MedPath

ELVR in PH Patients With Severe Emphysema

Completed
Conditions
COPD
Pulmonary Emphysema
Registration Number
NCT01393379
Lead Sponsor
Heidelberg University
Brief Summary

The purpose of this study is to investigate the effect of endoscopic valve implantation in patients with COPD and PH on hemodynamics, symptoms, exercise tolerance and quality of life in 10 patients in a prospective study. An improvement of objective parameters may also have a prognostic significance

Detailed Description

So far there is no treatment of COPD in addition to the established treatment of concomitant PH. Administration of PH-specific medication outside of clinical trials is not recommended in new guidelines for PH of the ERS/ESC. The influence of endobronchial valve implantation on the PH has not been studied in detail. The purpose of this study is to investigate the effect of endoscopic valve implantation in patients with COPD and PH on hemodynamics, symptoms, exercise tolerance and quality of life in 10 patients in a prospective study. An improvement of objective parameters may also have a prognostic significance

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
10
Inclusion Criteria
  • signed patient consent form
  • men and women >30 years
  • Clinically indicated endoscopic lung volume reduction
  • Pulmonary hypertension according to Group 3.1 of the Dana Point classification
  • Severe pulmonary emphysema
  • FEV1 <45%
  • RV> 150%
  • TLC> 100%
  • Maximum of medical therapy according to GOLD
  • heterogeneous emphysema
  • Detected in the HR-CT
  • Confirmation of the heterogeneity of emphysema by computer-assisted quantification (YACTA ®)
  • stable COPD
  • No exacerbation in the last 8 weeks
  • Cortisone dose <20 mg prednisolone equivalent
  • Non-or ex-smoker
  • Nicotine abstinence> 4 months
  • Actual CoHb <2.5%
  • Diagnosis of pulmonary hypertension (PH), invasively diagnosed by right heart catheterization:
  • Mean pulmonary arterial pressure (mPAP)> 25 mmHg
  • Pulmonary capillary wedge pressure (PCWP) <15 mmHg
  • Pulmonary vascular resistance (PVR)> 320 dyne * sec * cm-5
Exclusion Criteria
  • PH of Group 1, 2, 4, 5 of the Dana Point Classification
  • Previous operations
  • s/p Lung resection (lobectomy / pneumonectomy)
  • s/p endoscopic lung volume resection
  • significant bronchiectasis
  • Sputum volume> 4 tablespoons / day
  • Severe cardiac comorbidities:
  • s/p myocardial infarction in the last 6 weeks
  • Congestive heart failure
  • Cardiomyopathy with highly impaired LVF
  • Clopidogrel in long-term medication
  • Respiratory insufficiency: PaCO2 mmHg at rest> 55
  • current pregnancy

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Center for pulmonary Hypertension, Thoraxclinic Heidelberg

🇩🇪

Heidelberg, Germany

Center for pulmonary Hypertension, Thoraxclinic Heidelberg
🇩🇪Heidelberg, Germany
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