TY - JOUR T1 - Target lobar volume reduction and COPD outcome measures after endobronchial one-way valve therapy JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P2899 AU - Arschang Valipour AU - Felix J.F. Herth AU - Gerard J. Criner AU - Jean Michel Vergnon AU - Jonathan Goldin AU - Frank Sciurba AU - Armin Ernst Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P2899.abstract N2 - Introduction: Clinical effectiveness of endobronchial one-way valve therapy in patients with emphysema appears to be related to the extent of lobar volume reduction.Methods: Data derived from a multicentre study from 416 patients with severe emphysema (62% male, age 63±7yrs, FEV1 30±8%), who were randomized to valve therapy (n = 284) or conservative treatment (n = 132), were analyzed. Pulmonary function, exercise capacity, dyspnea scores, and CT analysis of target lobar volume reduction (TLVR) were assessed before and 6 months after valve therapy.Results: Of patients randomized to the treatment group, 49 (17%) showed > 50% target lobar volume reduction, 57 (20%) demonstrated TLVR between 20% and 50%, and 178 patients (63%) < 20% TLVR at 6 months post intervention (p < 0.01). Patients with TLVR > 50% demonstrated greater improvements in lung function parameters, exercise capacity (6-MWT), quality of life (SGRQ) and dyspnea score (mMRC) compared with the other groups. Consequently, BODE index was significantly improved by 1.4±1.8, 0.2±1.3, and 0.1±1.3 points in patients with TLVR > 50%, < 50% TLVR > 20%, and TLVR < 20%, respectively, whereas it worsened by 0.3±1.2 points in controls after 6 months (p<0.01 for inter-group differences). Logistic regression analysis identified target lobar volume reduction as the strongest independent predictor of improved BODE index scores from baseline to 6 months.Conclusions: The extent of lobar volume reduction predicts improvement in BODE index and health outcomes associated with bronchoscopic lung volume reduction using one-way valves. ER -