Comparative outcomes based on pre-Bronchoscopic lung volume reduction (BLVR) Six-minute walk distance (6MWD)

Bronchoscopic lung volume reduction (BLVR) is a minimally invasive procedure that improves shortness of breath and quality of life in some patients with emphysema. A key indicator of functional capacity for patients with underlying emphysema is a 6-min walk test (6MWD). This study aims to assess outcomes for patients who underwent BLVR stratified by 6MWD.

This single center, retrospective study analyzes patients who underwent BLVR. Patients were stratified into groups based on pre-BLVR 6MWD. The low functional capacity group walked between 100 and 250 m, the intermediate functional capacity group walked between 251 and 400 m, and the high functional capacity group walked greater than 400 m. The primary endpoint of this study is the percentage of FEV1 responders in each group based on pre-procedural 6MWD following BLVR. Secondary outcomes included changes in 6MWD and SGRQ for each group based on pre-procedural 6MWD following BLVR.

A total of 96 patients were stratified based on pre-BLVR 6MWD. At 12-months, patients in the low functional capacity group demonstrated an FEV1 responder rate of 51.6%, 48.1% in the intermediate functional capacity group, and high functionality group demonstrated an FEV1 responder rate of 30.8%. The average change in 6MWD following BLVR in the low functionality group was an increase by 53.3 m and an increase of 5.2 m in the intermediate functionality group. The average change in 6MWD in the high functionality group demonstrated a decrease by 53.2 m. Finally, the improvement in SGRQ in the low functionality group was 8.0, the improvement in the intermediate functionality group was 10.1, and the high functionality group showed an improvement by 10.1.

This study demonstrates that at 12-months there is no statistically significant association between pre-BLVR 6MWD testing and the FEV1 responder rate or the changes in mean SGRQ. Conversely, subjects in the high functional capacity group showed a statistically significant lower mean change in 6MWD compared to patients who walked less than 400 m. The greatest improvement in average 6MWD following BLVR was seen in the low functional capacity group.