TY - JOUR T1 - Heterogeneous and homogenous emphysema both respond to lung volume reduction coil treatment JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - 4731 AU - Dirk-Jan Slebos AU - Stefan Blaas AU - Gaëtan Deslee AU - Wolfgang Gesierich AU - Felix Herth AU - Juergen Hetzel AU - Martin Hetzel AU - Romain Kessler AU - Charles-Hugo Marquette AU - Michael Pfeifer AU - Franz Stanzel AU - Christian Witt Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/4731.abstract N2 - Rationale: The Lung Volume Reduction Coil (LVRC, PneumRx USA) is a bronchoscopic device for the treatment of patients with heterogeneous emphysema. In this study we investigated if the LVRC has potential in the treatment of homogenous emphysema.Methods: Using a post-hoc blinded CT analysis we tested the impact of degree of heterogeneity on 6-month outcome in patients after bilateral LVRC treatment in two recent trials (NCT01220908, NCT01328899). First, digital lobar CT emphysema scores were assessed using the % destruction below -950HU for both lungs. <25% difference between the ipsilateral lobes of both lungs was regarded homogeneous. Secondly, a visual pattern approach was used grading from 0 (no damage) to 4 (bullous disease). A difference of ≤1 point in one of the lungs was regarded as homogeneous disease.Results: 53 patients, 61.8y (±7.4), FEV1 33.8%pred (±9.8), RV 246%pred (±53) RV/TLC 60.6 (±9.1) were analyzed. Digital CT analyses identified 15 homogenous cases with a ΔFEV1 +7.8% (±11.9), ΔRV -0.77L (±0.55), Δ6MWD +41m (±85), ΔSGRQ -13.4pts (±11.3) and 38 heterogeneous cases with a ΔFEV1 +15.9% (±31.8), ΔRV -0.48L (±0.83), Δ6MWD +42m (±80), ΔSGRQ -10.9pts (±15.3). The visual approach resulted in 34 homogeneous cases with a ΔFEV1 +10% (±16), ΔRV -0.49L (±0.66), Δ6MWD +44m (±85), ΔSGRQ -9.6pts (±12.9), and 29 heterogeneous cases with a ΔFEV1 +18.3% (±37), ΔRV -0.61L (±0.85), Δ6MWD +42m (±59), ΔSGRQ -13.4pts (±15.3). Only FEV1 was different (p<0.01) between the two phenotypes.Conclusion: LVRC treatment also results in significant and clinically relevant improvements in patients with homogenous emphysema. These results warrant a prospective evaluation on LVRC in homogenous disease. ER -