Functional results of unilateral lung volume reduction surgery in alpha₁-antitrypsin deficient patients

Figures & data

Table 1 Baseline characteristics of patients with α₁-AT deficiency and without deficiency

Value	α1-AT deficient group n=17	Nondeficient group n=35	p
Age (years)	56 ± 9a	54 ± 11	0.62
BMI (m^2/kg)	20 ± 4	22 ± 4	0.07
Smoking habit (pack-years)	18.4 ± 14	41.1 ± 27	0.007
FEV1 (% pred)	22.2 ± 5.7	28 ± 11.9	0.06
FEV1 (ml)	613 ± 163	907 ± 453	0.013
FEV1 post-BD (% pred)	24 ± 6.7	29.9 ± 13	0.09
FVC (% pred)	48 ± 11	50 ± 17	0.65
RV (% pred)	278 ± 48	259 ± 71	0.34
FRC (% pred)	201 ± 35	182 ± 34	0.06
TLC (% pred)	138 ± 18	129 ± 21	0.15
IC (% pred)	62 ± 19	67 ± 18	0.37
6MWD (m)	237 ± 145	340 ± 173	0.039
Fletcher score	4.18 ± 0.73	3.57 ± 0.85	0.015
PaO2 (mmHg)	62 ± 9.7	67.6 ± 10.8	0.07
PaCO2 (mmHg)	40 ± 6.71	40.7 ± 6.1	0.7
PAP systolic (mmHg)	37 ± 7.3	36 ± 7.7	0.55

a Values are expressed as mean ± standard deviation.

Abbreviations: BD, bronchodilator; pred, predicted.

Table 2 Follow-up data after LVRS in the α₁-AT deficient and nondeficient groups

Group		FEV1 (% pred)	RV (% pred)	TLC (% pred)	FRC (% pred)	6MWD (m)	dyspnea score	PaO2 (mmHg)	PaCO2 (mmHg)
α1-AT deficiency	pre-op (n = 17)	22.2 ± 5.7a	278 ± 48	138 ± 18	201 ± 35	237 ± 145	4.18 ± 0.73	62 ± 9.7	40 ± 6.71
	3–6 months (n = 17)	28.9 ± 11.2*	248 ± 57	132 ± 16	191 ± 28	310 ± 154*	3.1 ± 0.9*	67 ± 6.8*	38 ± 4.4
	12 months (n = 16)	25.9 ± 9.1*	259 ± 13.5	133 ± 20	200 ± 32	270 ± 151	3.2 ± 0.6*	65.2 ± 8.2	38.6 ± 4
nondeficient group	pre-op (n = 35)	28 ± 11.9	259 ± 71	129 ± 21	182 ± 34	340 ± 173	3.57 ± 0.85	67.6 ± 10.8	40.7 ± 6.1
	3–6 months (n = 33)	36.6 ± 16.8*	217 ± 71*	119 ± 20*	166 ± 37*	408 ± 163*	2.7 ± 1.2*	72.3 ± 12.4*	40.2 ± 6.1
	12 months (n = 26)	39.7 ± 17.2*	209 ± 63*	119 ± 18*	161 ± 32*	421 ± 153*	2.6 ± 1.2*	71.8 ± 9.3*	38.5 ± 3.5

* Significantly different from baseline value.

a Values are expressed as mean ± standard deviation.

Abbreviations: pred, predicted; pre-op, pre-operatively.

Figure 1 Evolution of FEV₁ before LVRS, at 3–6 months, and at 1 year after LVRS.

Figure 2 Evolution of dyspnea score before LVRS, at 3–6 months, and at 1 year after LVRS.

Figure 3 Evolution of 6MWD before LVRS, at 3–6 months, and at 1 year after LVRS.

*p < 0.05 compared with pre-operative values.

*p < 0.05 compared with pre-operative values.

*p < 0.05 compared with pre-operative values.

Figure 2 Evolution of dyspnea score before LVRS, at 3–6 months, and at 1 year after LVRS.

Figure 3 Evolution of 6MWD before LVRS, at 3–6 months, and at 1 year after LVRS.

*p < 0.05 compared with pre-operative values.

*p < 0.05 compared with pre-operative values.

Figure 3 Evolution of 6MWD before LVRS, at 3–6 months, and at 1 year after LVRS.

*p < 0.05 compared with pre-operative values.

Table 3 Number of patients with persistent increase in FEV₁ and 6MWD according to α₁-AT deficiency status (gain expressed in comparison with baseline)

Parameters	Group	at 6 months		at 12 months
		n	%	n	%
gain in FEV1
> 150 ml	nondeficient	13/33	39.4	9/26	34.6
	deficient	4/17	23.5	3/16	18.7
gain in 6MWD
> 50 m	nondeficient	21/33	63.6	15/26	57.7
	deficient	12/17	70.6	6/17	35.3