Patients suffering from extreme emphysema show improved cardiac function with bronchoscopic lung volume reduction.

Performing Procedures

Advanced Bronchoscopy Helps Cardiac Function in Patients With Severe Emphysema

“These results suggest that heart failure is at least partially reversible in this patient group and elucidate the interaction between hyperinflation and cardiac function."

Patients suffering severe emphysema who underwent advanced bronchoscopy — in the form of bronchoscopic lung volume reduction — experienced improved cardiac function, according to new research.

The study, which found improvements following bronchoscopic lung volume reduction with endobronchial valves, was published in the American Journal of Respiratory Critical Care Medicine.

Emphysema severity in patients with COPD has repeatedly been associated with decreased cardiac chamber sizes, study investigator Dr. Marieke C. van der Molen told Healio in an interview.

“The presence of concomitant heart failure strongly impacts morbidity and mortality in this patient group,” she said.

Van der Molen and her coauthors theorized that hyperinflation reduction would enhance cardiac preload — the initial stretching of the heart muscles before contraction — in patients with severe emphysema.

The results of their study of 24 patients showed significant improvements in right ventricle end-diastolic volume index and increases in stroke volume. The patients also saw quality-of-life improvements.

“These results suggest that heart failure is at least partially reversible in this patient group and elucidate the interaction between hyperinflation and cardiac function,” Van der Molen said.

Severe emphysema with hyperinflation is the end stage of the chronic obstructive pulmonary disease (COPD) spectrum, according to an accompanying editorial by Dr. Justin L. Garner and Dr. Pallav L. Shah of Royal Brompton Hospital. It is characterized by progressive and irreversible airflow limitation and counts heart failure among its common comorbidities.

Lung volume reduction, whether done surgically or through bronchoscopy, has been found to restore normal function to the intrathoracic mechanics of patients suffering from severe emphysema and hyperinflation.

The cohort of this study was small and additional research is needed, the authors of the editorial say.

Ambu recently launched its Ambu® aScope™ 5 Broncho HD System for the bronchoscopy suite, which offers all the familiar features of reusables with the advantages of single-use. The scope was specifically designed for advanced bronchoscopy procedures.

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