TY - JOUR T1 - Endoscopic lung volume reduction with endobronchial valves in very low DLCO patients: results from the German Registry (Lungenemphysemregister e.V.) JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00449-2020 SP - 00449-2020 AU - Pavlina Lenga AU - Christoph Ruwwe-Glösenkamp AU - Christian Grah AU - Joachim Pfannschmidt AU - Jens Rückert AU - Stephan Eggeling AU - Sven Gläser AU - Bernd Schmidt AU - Paul Schneider AU - Sylke Kurz AU - Gunda Leschber AU - Andreas Gebhardt AU - Birgit Becke AU - Olaf Schega AU - Jakob Borchardt AU - Ralf-Harto Hübner Y1 - 2020/01/01 UR - http://openres.ersjournals.com/content/early/2020/10/01/23120541.00449-2020.abstract N2 - Background Endoscopic lung volume reduction (ELVR) with valves has been suggested to be the key strategy for patients with severe emphysema and concomitant low diffusion capacity of the lung for carbon monoxide (DLCO). However, robust evidence is still missing. We therefore aim to compare clinical outcomes in relation to DLCO for patients treated with ELVR.Methods We assessed DLCO at baseline and 3-months follow-up and compared pre- and postprocedural pulmonary function test (PFT), quality of life, exercise capacity and adverse events. This is a retrospective subanalysis of prospectively collected data from the German Lung Emphysema Registry.Results 121 patients treated with ELVR were analysed. 34 patients with a DLCO ≤20% and 87 patients with a DLCO >20% showed similar baseline characteristics. After ELVR, there was a decrease of residual volume (both p<0.001 to baseline) in both groups and both demonstrated better quality of life (p<0.01 to baseline). Forced expiratory volume in 1 s (FEV1) improved significantly only in patients with a DLCO >20% (p<0.001 to baseline). Exercise capacity remained almost unchanged in both groups (p=0.3). The most frequent complication for both groups was a pneumothorax (DLCO ≤20%: 17.6% versus DLCO >20%: 16.1%; p=0.728). However, there were no significant differences in other adverse events between both groups.Conclusions ELVR improves lung function as well as quality of life in patients with DLCO >20% and DLCO ≤20%. Adverse events did not differ between groups. Therefore, ELVR should be considered as a treatment option, even in patients with a very low DLCO.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Lenga has nothing to disclose.Conflict of interest: Dr. Ruwwe-Glösenkamp has nothing do discloseConflict of interest: Dr. Grah has nothing to disclose.Conflict of interest: Dr. Pfannschmidt has nothing to disclose.Conflict of interest: Prof. Rückert has nothing to disclose.Conflict of interest: Dr. Eggeling has nothing to disclose.Conflict of interest: Dr. Schmidt has nothing to disclose.Conflict of interest: Dr. Schneider has nothing to disclose.Conflict of interest: Dr. Sven has nothing to disclose.Dr. Kurz has nothing to disclose.Conflict of interest: Dr. Leschber has nothing to disclose.Conflict of interest: Dr. Gebhardt has nothing to disclose.Conflict of interest: Dr. Schega has nothing to disclose.Conflict of interest: Dr. Borchardt has nothing to disclose.Conflict of interest: Dr. Hübner reports personal fees and non-financial support from Pulmonx, from null, from null, from null, from null, from null, from null, from null, outside the submitted work; .Dr. Hübner reports personal fees and non-financial support from Pulmonx, outside the submitted work.Conflict of interest: Dr. Birgit has nothing to disclose.Conflict of interest: Dr. Glaeser reports personal fees from Boehringer Ingelheim, grants and personal fees from Novartis Pharma, personal fees from Roche Pharma, personal fees from Berlin Chemie, personal fees from PneumRx, personal fees from PulmonX, personal fees from Actelion Pharma, personal fees from Bayer Healthcare, outside the submitted work. ER -