The effect of endoscopic lung volume reduction on functional outcomes in patients with severe emphysema

Abstract

Introduction: Endoscopic lung volume reduction (ELVR) improves lung function in patients with severe emphysema. The effect on physical activity (PA), muscle strength and symptoms during exercise is less known. Methods: 40 patients with severe emphysema were enrolled in the BEVA study (NCT03264768) comparing ELVR (n=20) with routine care (n=18). Allocation was based on collateral ventilation (Chartis). Present interim analysis at 3 months includes 16 ELVR and 14 controls. We compared changes in lung function (FEV1), exercise capacity (6MWD), quality of life (QoL) and PA between both groups. Changes in muscle force, endurance cycling time and symptoms during exercise were only measured in ELVR group. Results: Compared to controls, ELVR significantly improved FEV1, 6MWD and QoL, while PA (steps per day) did not change significantly (figure 1). EBV patients had significant improvements in respiratory muscle force (ΔMIP:-17±22cmH2O; p=0.04; ΔMEP: 40±42cmH2O; p=0.01) and endurance cycling time (Δ496±509s; p=0.004). Symptoms of dyspnea at isotime significantly decreased (Δ-2.4±3.6; p=0.03), particularly in the group with complete atelectasis (Δ-3.3±3; p=0.004). Conclusion: Improvements of FEV1, 6MWD and QoL obtained with ELVR does not translate in significant improvements of PA 3 months post ELVR. Increased exercise capacity and reduction of symptoms during exercise highlight the potential for activity coaching post ELVR.