Post-EBV exercise capacity tied to survival in patients

Among patients with advanced emphysema who have undergone bronchoscopic lung volume reduction using endobronchial valves (EBV), those with improvement in exercise capacity and quality of life have better survival, as reported in a study.

Researchers assessed treatment response at the 6-week and 1-year follow-up in a cohort of patients treated with EBVs. Patients were categorized as responders or nonresponders based on known minimal important differences for forced expiratory volume (FEV1), residual volume (RV), RV/total lung capacity (TLC) ratio, 6-min walk distance (6MWD), St. George's Respiratory Questionnaire (SGRQ), target lobe volume reduction (TLVR), and complete lobar atelectasis.

The analysis included a total of 428 patients. In multivariate cox regression models, EBV treatment led to favourable improvements in pulmonary function, exercise capacity, and quality of life. The median survival after treatment was 8.2 years.

Independent predictors of survival were SGRQ (hazard ratio (HR), 0.50, 95 percent confidence interval [CI], 0.28–0.89; p=0.02) and 6MWD response (HR, 0.54, 95 percent CI, 0.30–0.94; p=0.03). Moreover, the presence of a complete lobar atelectasis and improvements in pulmonary function had no significant effect on survival.

EBV is used to treat selected patients with advanced emphysema and has been shown to significantly improve pulmonary function, exercise capacity, and quality of life, with potentially survival gains. The findings of the present study show that treatment response to EBV may influence survival time.