Effective Bronchoscopic Lung Volume Reduction Accelerates Exercise Oxygen Uptake Kinetics in Emphysema
Faisal, A., Zoumot, Zaid, Shah, Pallav L., Neder, J. Alberto, Polkey, Michael I. and Hopkinson, Nicholas S. 2016. Effective Bronchoscopic Lung Volume Reduction Accelerates Exercise Oxygen Uptake Kinetics in Emphysema. Chest. 149 (2), pp. 435-446. https://doi.org/10.1378/chest.15-0404
|Authors||Faisal, A., Zoumot, Zaid, Shah, Pallav L., Neder, J. Alberto, Polkey, Michael I. and Hopkinson, Nicholas S.|
The impact of bronchoscopic lung volume reduction (BLVR) on physiologic responses to exercise in patients with advanced emphysema remains incompletely understood. We hypothesized that effective BLVR (e-BLVR), defined as a reduction in residual volume > 350 mL, would improve cardiovascular responses to exercise and accelerate oxygen uptake (
Thirty-one patients (FEV1, 36% ± 9% predicted; residual volume, 219% ± 57% predicted) underwent a constant intensity exercise test at 70% peak work rate to the limit of tolerance before and after treatment bronchoscopy (n = 24) or sham bronchoscopy (n = 7). Physiologic responses in patients who had e-BLVR (n = 16) were compared with control subjects (ineffective BLVR or sham bronchoscopy; n = 15).
e-BLVR reduced residual volume (−1.1 ± 0.5 L, P = .001), improved lung diffusing capacity by 12% ± 13% (P = .001), and increased exercise tolerance by 181 ± 214 s (P = .004).
o2 kinetics in the e-BLVR group were significantly correlated with reductions in residual volume (r = 0.66, P = .005) and improvements in inspiratory reserve volume (r = 0.56, P = .024) and exercise tolerance (r = 0.63, P = .008).
Lung deflation induced by e-BLVR accelerated exercise
o2 kinetics in patients with emphysema. This beneficial effect appears to be related mechanistically to an enhanced cardiovascular response to exercise, which may contribute to improved functional capacity.
|Journal citation||149 (2), pp. 435-446|
|Digital Object Identifier (DOI)||https://doi.org/10.1378/chest.15-0404|
|Web address (URL)||https://doi.org/10.1378/chest.15-0404|
|12 Jan 2016|
|Publication process dates|
|Deposited||13 Sep 2017|
|Copyright information||© 2016 Elsevier|
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