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CT-derived muscle remodelling after bronchoscopic lung volume reduction in advanced emphysema
  1. Karin J C Sanders1,
  2. Karin Klooster2,
  3. Lowie E G W Vanfleteren3,
  4. Dirk-Jan Slebos2,
  5. Annemie M W J Schols1
  1. 1 Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
  2. 2 Department of Pulmonary Diseases, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
  3. 3 COPD Centre Sahlgrenska University, Gothenburg, Sweden
  1. Correspondence to Professor Annemie M W J Schols, Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht 200 MD, The Netherlands; a.schols{at}maastrichtuniversity.nl

Abstract

Muscle wasting frequently occurs in severe emphysema. Improving respiratory mechanics by bronchoscopic lung volume reduction using endobronchial valves (EBV) might prevent further loss or even increase in muscle mass. CT-derived skeletal muscle mass gain was observed in 39/49 patients 6 months after EBV. Multiple linear regression showed that gain in muscle (β=2.4; 95% CI 0.2 to 4.6; p=0.036) and intramuscular fat (β=3.1; 95% CI 0.2 to 5.9; p=0.035) is associated with improved 6 min walk distance independent of the change in residual volume. Skeletal muscle remodelling associates with improved exercise capacity after EBV, independent of hyperinflation reduction.

Trial registration number Clinical trial registered with the Dutch trial register www.trialregister.nl (NTR2876), Results.

  • emphysema
  • systemic disease and lungs
  • imaging/ct mri etc
  • lung volume reduction surgery

https://doi.org/10.1136/thoraxjnl-2018-211931

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    Footnotes

    • Contributors KJCS, KK, D-JS and AMWJS contributed to the conception and design of the article. KJCS and AMWJS contributed to the analysis of data. All authors contributed to the interpretation of data, drafting of the manuscript, critically revised the article and gave final approval of this version to be submitted.

    • Funding Supported by MUMC2020 grant. The sponsor was not involved in the study design, data collection and analysis, writing of the report and in the decision for publication.

    • Competing interests KJCS has nothing to disclose. KK reports non-financial support from ZonMW, The Hague, NL (government granting agency), during the conduct of the study; grants, personal fees, non-financial support and other from PneumRx/BTG, CA, USA, grants, personal fees, non-financial support and other from PulmonX, CA, USA, outside the submitted work. LEGWV has nothing to disclose. D-JS reports grants, personal fees, non-financial support and other from PulmonX Inc., CA, USA, outside the submitted work. AMWJS has nothing to disclose.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.