Invasive RV pressure-volume loops show hemodynamic benefits of reducing lung hyperinflation in COPD
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Updated: Oct 30, 2026
Closed Chest Biventricular Pressure-Volume Loop Recordings with Admittance Catheters in a Porcine Model
Published on: May 18, 2021
Juliette Rohou1, Clément Boissin1, Jean Pierre Mallet1
1PhyMedExp, Department of Respiratory Disease, Univ Montpellier, INSERM, CNRS, CHU, Montpellier, France.
Aims:
Right heart dysfunction is a common complication in chronic obstructive pulmonary disease (COPD), yet the underlying mechanisms remain poorly understood. Endoscopic lung volume reduction (ELVR) using Zephyr® valves improves lung function by reducing emphysema-induced hyperinflation, providing clinical benefits beyond enhanced pulmonary mechanics. Magnetic resonance imaging studies suggest that alleviating lung hyperinflation may also positively affect left heart function. We hypothesized that ELVR may also improve right heart function.
Research Question:
This study evaluated right heart function after ELVR in patients with COPD using invasive pressure-volume loop analysis.
Study Design And Methods:
Eleven patients with severe COPD underwent baseline right heart catheterization because of suspected pulmonary hypertension, and pressure-volume loop analysis. Eight patients underwent ELVR, followed by right heart function reassessment 12 weeks post-procedure.
Results:
Pre-ELVR, pulmonary artery pressures ranged from 23 to 32 mmHg, vascular resistance was 2.2-4.8 WU, and significant impaired pressure-volume indexes were observed compared to reference data. Post-ELVR, lung hyperinflation improved significantly, with a reduction in the Residual Volume /Total Lung Capacity (RV/TLC) ratio. RV/TLC changes correlated with improvements in end-diastolic pressure-volume relationships (r=0.82, P=0.02) and the time constant of relaxation Tau (r=0.84, P=0.01). Functional outcomes, such as 6-minute walk distance and dyspnea scores, were driven by stroke work and diastolic parameters, respectively.
Conclusions:
In this exploratory single center study, endoscopic lung volume reduction with associated improvement in hyperinflation led to significant improvement in exercise capacity and in right ventricular function.
