Response to endobronchial valve treatment: it's all about the target lobe!

Background Bronchoscopic lung volume reduction using endobronchial valves (EBV) has shown to be beneficial for severe emphysema patients. The most important predictor of treatment response is absence collateral ventilation between the target and ipsilateral lobe. However, there are still a substantial number non-responders it would useful improve pre-treatment identification responders. Presumably, predictors will multifactorial therefore our aim was explore whether we can identify groups clusteranalysis. Methods At baseline 1 year follow-up, pulmonary function, exercise capacity quality life were measured. A quantitative chest CT scan analysis performed at 2 6 months follow-up. cluster hierarchical agglomerative method. Results In total 428 patients (69%female, age 61±8 years, FEV 27±8%pred, RV 254±50%pred) included in analysis. Three clusters generated: non-responder responder clusters. Despite solid technical procedures, had significantly less clinical after compared other characterised by emphysematous destruction, air trapping higher perfusion lobe, more homogeneous distribution Conclusions We found that lobe characteristics discriminators responders which underlines importance visual assessment potential when selecting EBV treatment.