title: Predictors of clinical outcome in emphysema patients with atelectasis following endoscopic valve therapy: A retrospective study.
abstract: The aim of endoscopic valve therapy in patients with emphysema is complete lobar atelectasis of the most emphysematous lobe. However, even after the radiological advent of atelectasis, great variability in clinical outcomes can be observed.
  
  
  
  The baseline clinical measures (vital capacity (VC), forced expiratory flow in 1 s (FEV1 ), residual volume (RV) and 6-min walk test (6-MWT)) and computed tomography variables (low attenuation volume (LAV) of the target lobe, LAV% of the target and the ipsilateral untreated lobe and LAV of the target lobe to LAV of the target lung and to LAV of the total lung) of 77 patients with complete atelectasis following valve therapy were retrospectively examined to determine their impact on patient´s outcome (changes in VC, FEV1 , RV and 6-MWT from baseline to the time of atelectasis).
  
  
  
  Low attenuation volume of the target lobe to LAV of the target lung predicts a significant FEV1 improvement in patients with complete lobar atelectasis following valve therapy. A 10% difference in that computed tomography predictor was associated with a 82-mL improvement in FEV1 (P = 0.006). Lower 6-MWT scores, low VC and high RV at baseline were significantly associated with greater improvement in the respective parameter (all P < 0.001).
  
  
  
  Low attenuation volume of the target lobe to LAV of the target lung and baseline clinical measures seem to significantly predict clinical outcomes in patients with complete lobar atelectasis following valve treatment.
authors.affiliation: Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany. daniela.gompelmann@med.uni-heidelberg.de.|Member of the German Center for Lung Research, Heidelberg, Germany. daniela.gompelmann@med.uni-heidelberg.de.
authors.forename: Daniela
authors.initials: D
authors.lastname: Gompelmann
authors.affiliation: Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Hofbauer
authors.affiliation: First Critical Care Department, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Gerovasili
authors.affiliation: Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany.|Member of the German Center for Lung Research, Heidelberg, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Eberhardt
authors.affiliation: Diagnostic and Interventional Radiology, Thoraxklinik at University of Heidelberg, Heidelberg, Germany.
authors.forename: Hyun-Ju
authors.initials: HJ
authors.lastname: Lim
authors.affiliation: Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany.|Member of the German Center for Lung Research, Heidelberg, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Herth
authors.affiliation: Member of the German Center for Lung Research, Heidelberg, Germany.|Diagnostic and Interventional Radiology, Thoraxklinik at University of Heidelberg, Heidelberg, Germany.
authors.forename: Claus-Peter
authors.initials: CP
authors.lastname: Heussel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging / Q000209:etiology*; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012115:Residual Volume; D012189:Retrospective Studies; D012307:Risk Factors; D013990:Tidal Volume; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014797:Vital Capacity
keywords: Endoscopic lung volume reduction; atelectasis; computed tomography analysis; emphysema; valve therapy