Reduction of COPD Hyperinflation by Endobronchial Valves Improves Intercostal Muscle Morphology on Ultrasound

Figures & data

Table 1 Baseline Demographics

Sex	Male: 7 (88%) Female: 1
Age (years)	73.4 (5.6)
BMI (kg/m^2)	21.8 (3.1)
Current smoker	0
FEV1 (litres)	1.02 (0.37)
FEV1 (% predicted)	36% (12.5)
Diffusion capacity (% predicted)	35 (5)
Residual volume (litres)	5.25 (1.23)
Residual volume (% predicted)	202 (41)
6-minute walk test distance (metres) (n =6)	260 (69)
Age-adjusted Charlson Comorbidity Index*	4 (4,5)
International Physical Activity Questionnaire (n = 6) #	Low = 4 Med = 0 High = 2
Modified Medical Research Council Scale (mMRC) n = 6*	3 (3,4)
St George Respiratory Questionnaire (Baseline) n = 7	63.5 (40.12, 70.16)

Notes: All data are mean (SD) unless specified. *(Median (range). #: Scored according to IPAQ research committee protocol, accessed at https://sites.google.com/site/theipaq/home.

Figure 1 Parasternal intercostal muscle ultrasound.

Notes: (A) Ultrasound image of parasternal intercostal muscle; (B) Square method for measurement of parasternal intercostal echogenicity.

Abbreviations: R, ribs; PM, pectoralis major; Arrows, fascial border of parasternal intercostal muscle.

Table 2 Pre- and Post-Physiological and QoL Results

	PRE-EBV	POST-EBV
FEV1 (L)	1.02 (0.37)	1.14 (0.37)
FEV1% predicted	36% (12.5)	42% (18.4)
Residual volume (L)	5.25 (1.23)	4.74 (1.09)
CT lung volume treated side (mL)**	3600 (650.9)	2988 (785.9)
CT lung volume non-treated side (mL)	3282 (567.2)	3463 (575.2)
CT target lobe volume (mL)***	2143 (426.4)	1256 (653.3)
SGRQ (median, IQR)#	63.5 (60.6–64.5)	48.1 (44.1–69.7)

Notes: Mean (SD) unless specified; Paired t-test unless specified; **Significant difference (p = 0.03). ***Significant difference (p0.003); # Wilcoxon test.

Abbreviations: FEV₁, forced expiratory volume in 1 second; CT, computed tomography; SGRQ, St George’s Respiratory Questionnaire.

Figure 2 Relationship between change in residual volume, CT-target lobe volume and change in parasternal thickness following endobronchial valve insertion.

Notes: Regression line of change in parasternal muscle thickness compared to change in residual volume (dotted lines = 95% confidence interval).

Abbreviations: RV, residual volume (litres); Target lobe vol, CT-measured target lobe volume (litres); IC2, 2nd intercostal muscle (parasternal).