• Daniela Gompelmann, Tobias Hofbauer, Vasiliki Gerovasili, Ralf Eberhardt, Hyun-Ju Lim, Felix Herth, and Claus-Peter Heussel.
• Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany. daniela.gompelmann@med.uni-heidelberg.de.
• Respirology. 2016 Oct 1; 21 (7): 1255-61.

Background And ObjectiveThe 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.MethodsThe 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).ResultsLow 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).ConclusionLow 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.© 2016 Asian Pacific Society of Respirology.

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