C Witt

Charité Universitätsmedizin Berlin, Berlín, Berlin, Germany

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Publications (167)503.31 Total impact


  • No preview · Article · Dec 2015

  • No preview · Article · Sep 2015 · European Respiratory Journal

  • No preview · Article · Sep 2015 · European Respiratory Journal
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    ABSTRACT: Bronchoscopic coil treatment has been shown to improve pulmonary function, exercise capacity, and quality of life in patients with severe emphysema. To perform a meta-analysis of the results of four independent European clinical trials investigating this coil therapy for emphysema. Data on all patients included in the four European clinical trials were analyzed for efficacy and safety outcomes. A total of 2,536 coils were placed during 259 procedures in 140 patients. A total of 37 chronic obstructive pulmonary disease exacerbations and 27 pneumonias were recorded as serious adverse events up to 1 year after treatment. The pneumothorax rate was 6.4%. Both 6 and 12 months after treatment, significant (all p < 0.001) improvements were observed for: forced expiratory volume in 1 s [+0.08 liters (±0.19) and +0.08 liters (±0.21)], residual volume [RV; -510 ml (±850) and -430 ml (±720)], 6-min walking distance [6MWD; +44.1 m (±69.8) and +38.1 m (±71.9)], and St. George's Respiratory Questionnaire score [SGRQ; -9.5 points (±14.3) and -7.7 points (±14.2)]. No differences in any outcome measures were observed between heterogeneous and homogeneous emphysema patients. Only a high baseline RV was found to be an independent predictor of successful treatment. Bronchoscopic coil treatment improves pulmonary function, 6MWD, and quality of life in patients with severe emphysema up to 1 year after treatment, independent of the distribution of the disease. © 2015 S. Karger AG, Basel.
    No preview · Article · Jun 2015 · Respiration
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    ABSTRACT: Erlotinib with bevacizumab showed promising activity in recurrent nonsquamous (NS) nonsmall cell lung cancer (NSCLC). The INNOVATIONS study was designed to assess in first-line treatment of unselected cisplatin-eligible patients this combination compared to cisplatin, gemcitabine and bevacizumab. Stage IIIB/IV patients with NS-NSCLC were randomised on erlotinib (150 mg daily) and bevacizumab (15 mg·kg(-1) on day 1, every 3 weeks) (EB) until progression, or cisplatin (80 mg·m(-2) on day 1, every 3 weeks) and gemcitabine (1250 mg·m(-2) on days 1 and 8, every 3 weeks) up to six cycles and bevacizumab (15 mg·kg(-1) on day 1, every 3 weeks) (PGB) until progression. 224 patients were randomised (EB n=111, PGB n=113). The response rate (12% versus 36%; p<0.0001), progression-free survival (median 3.5 versus 6.9 months; hazard ratio (HR) 1.85, 95% CI 1.39-2.45; p<0.0001) and overall survival (median 12.6 versus 17.8 months; HR 1.41, 95% CI 1.01-1.97; p=0.04) clearly favoured PGB. In patients with epidermal growth factor receptor mutations (n=32), response rate, progression-free survival and overall survival were not superior with EB. Platinum-based combination chemotherapy remains the standard of care in first-line treatment of unselected NS-NSCLC. Molecular targeted approaches strongly mandate appropriate testing and patient selection. Copyright ©ERS 2015.
    Full-text · Article · Mar 2015 · European Respiratory Journal

  • No preview · Article · Feb 2015 · Pneumologie
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    ABSTRACT: Ziel der Studie: Die Metropolregion Berlin verzeichnet ca. 1600 Todesfälle/Jahr in folge urbanen Hitzstresses. Zusätzlich, nimmt die Morbidität bei chronischen Lungenkrankheiten durch Hitzestress zu, die zur Hospitalisierung via Notaufnahme führen kann. Folglich wurde geprüft, ob Innenraumklimatisierung den Hospitalisierungsverlauf vulnerabler Patienten beeinflusst in Hinblick auf den Flüssigkeitshaushalt und CAT score. Methoden: Prospektiv-randomisiert wurden 33 Patienten (Durchschnittsalter 69,52 Jahre, BMI 24,61, COPD IV 33,33%) mit Verlausfsverschlechterung chronischer Lungenkrankheit (zumeist COPD) in einer Pilotauswertung untersucht. Studieneinschluss erfolgte im Verhältnis 1:1 in klimatisierte oder unklimatisierte Krankenzimmer. Die Innenraumtemperatur wurde konstant bei 23 °C mittels Kältemittel-führenden Kapillarrohrmatten unter Zimmerdecken- Oberfläche gehalten (Fa. CLINA Heiz-& Kühlelemente GmbH, Berlin), betrug hingegen in nicht-klimatisierten Zimmern im Sommer 2014: 24,2 °C- 28,2 °C. Gemessene Innenraum- sowie meteorologische Außenparameter erlauben, die Hitzebelastung auf Patienten zu beurteilen. Vegetative und funktionelle Parameter, u.a. Trinkmenge und Fragebögen (CAT, HADS-S, SGRQ, MMRC) waren Bewertungsgrundlage. Ergebnisse und Ausblick: Die erste Auswertung zeigt, dass die Patienten in klimatisierten Zimmern, im Unterscheid zu den Patienten in unklimatisierten Krankenzimmern eine geringere Trinkmenge zuführten (1,62 l versus 2,17 l, p < 0,05). Der CAT Score sank in klimatisierten Zimmern mehr (1,25 Punkte) als bei Patienten im unklimatisierten Setting (0,857 Punkte, p < 0,05). Folglich hat die Krankenzimmer-Klimatisierung unterstützenden Einfluss auf vulnerable chronisch-kranke Lungenpatienten während der Hospitalisierung. In Hinblick auf den Klimawandel und die damit verbundene weitere Erwärmung könnte Klimatisierung eine Adaptationsstrategie im Krankenzimmer der Zukunft für Lungenkranke sein. Förderung: DFG FOR 1736 (UCaHS)
    No preview · Article · Feb 2015 · Pneumologie
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    ABSTRACT: Background The lung volume reduction (LVR) coil is a minimally invasive bronchoscopic nitinol device designed to reduce hyperinflation and improve elastic recoil in severe emphysema. We investigated the feasibility, safety and efficacy of LVR coil treatment in a prospective multicentre cohort trial in patients with severe emphysema. Methods Patients were treated in 11 centres. Safety was evaluated by recording all adverse events, efficacy by the St George's Respiratory Questionnaire (SGRQ) as primary endpoint, and pulmonary function testing, modified Medical Research Council dyspnoea score (mMRC) and 6-min walk distance (6MWD) up to 12 months after the final treatment. Results Sixty patients (60.9 +/- 7.5 years, forced expiratory volume in 1 s (FEV1) 30.2 +/- 6.3% pred) were bronchoscopically treated with coils (55 bilateral, 5 unilateral), with a median of 10 (range 5-15) coils per lobe. Within 30 days post-treatment, seven chronic obstructive pulmonary disease exacerbations (6.1%), six pneumonias (5.2%), four pneumothoraces (3.5%) and one haemoptysis (0.9%) occurred as serious adverse events. At 6 and 12 months, respectively, Delta SGRQ was -12.1 +/- 12.9 and -11.1 +/- 13.3 points, Delta 6MWD was +29.7 +/- 74.1 m and +51.4 +/- 76 m, Delta FEV1 was +0.11 +/- 0.20 L and +0.11 +/- 0.30 L, and Delta RV (residual volume) was -0.65 +/- 0.90 L and -0.71 +/- 0.81 L (all p<0.01). Post hoc analyses showed significant responses for SGRQ, 6MWD and RV in patients with both heterogeneous and homogeneous emphysema. Conclusions LVR coil treatment results in significant clinical improvements in patients with severe emphysema, with a good safety profile and sustained results for up to 1 year.
    Full-text · Article · Jun 2014 · Thorax
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    ABSTRACT: Summer heat waves with temperature extremes are becoming more frequent with growing numbers in morbidity and mortality in patients with respiratory diseases. The aim of this study was to evaluate the ramifications of heat stress (temperature >25 °C) on the health status of patients with pulmonary arterial hypertension (PAH). Fifteen patients with PAH (mean age = 66.7 ± 5.2 years) continuously wore an accelerometer from April 1 to September 30, 2011, and their daily step count was recorded. In addition, patients kept a diary to record data on seven standardized questions regarding their daily symptoms. Echocardiography, 6-minute walk test, NTproBNP, and Modified Medical Research Council Scale (MMRC) were assessed at baseline and at the end of the study after 6 months. On heat-stress days, patients showed significantly more symptoms and lower total steps/day compared to thermal comfort days (3,995 ± 2,013 steps/day vs. 5,567 ± 2,434 steps/day, respectively; P < 0.001). There was a significant negative correlation between total steps/day and Tempmax (R = -0.47; P < 0.001) and humidity (R = -0.34; P < 0.001). A significant positive correlation was found between daily symptoms and Tempmax (R = +0.79; P < 0.001) and humidity (R = +0.23; P < 0.001). Heat stress is associated with a compromised clinical status in patients with PAH. Adaptation strategies must be implemented to prevent heart-related morbidity, including therapeutic adjustments and adequate room cooling in the patient's home and at the hospital.
    Full-text · Article · May 2014 · Beiträge zur Klinik der Tuberkulose
  • M. Jehn · C. Witt
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    ABSTRACT: Hintergrund Der Klimawandel führt zu einer Zunahme von Temperaturextremen, indem es mehr heiße und mehr kalte Rekordtage geben wird. Patienten mit chronisch obstruktiver Bronchitis sind demnach einem erhöhten Morbiditäts- und Mortalitätsrisiko ausgesetzt. Fragestellung Ein telemedizinisches Monitoringsystem wurde entwickelt, um die Auswirkungen von Hitzestress (Tage > 25 °C) auf den klinischen Zustand zu evaluieren. Methoden Es wurden 62 Patienten in die Studie eingeschlossen und entweder in eine Telemedizingruppe (n = 32) oder Kontrollgruppe (n = 30) randomisiert. Das Telemonitoring beinhaltete die Erfassung des klinischen Zustands (COPD-Assessment-Test, CAT), eine tägliche Lungenfunktionsmessung (FEV1) und einen wöchentlichen 6-Minuten-Gehtest (6MWT). Die Beobachtungsdauer betrug insgesamt 9 Monate. Ergebnisse Im Zeitraum vom 1. Juni bis 31. August 2012 wurden insgesamt 32 Tage mit Hitzestress gezählt (mittlere Lufttemperatur 29 ± 2,5 °C) und mit 32 Tagen ohne Hitzestress aus dem gleichen Zeitraum verglichen (mittlere Lufttemperatur 21 ± 2,9 °C). An Tagen mit Hitzestress zeigten die Patienten in der Telemedizingruppe eine signifikante Verschlechterung der Lungenfunktion, der körperlichen Leistungsfähigkeit im 6MWT und ihres klinischen Zustands gemessen am CAT-Fragebogen. In den Sommermonaten erlitten 3 Patienten der Telemedizingruppe einen durch akute Luftnot bedingten Anfall (Exazerbation) im Vergleich zu 14 Kontrollpatienten. Über die gesamte 9-monatige Beobachtungsdauer zeigten die Patienten in der Telemedizingruppe insgesamt weniger Exazerbationen im Vergleich zur Kontrollgruppe, eine kürzere Krankenhausliegedauer und weniger Konsultationen beim Lungenarzt. Schlussfolgerungen Patienten mit COPD sind vom Hitzestress stark betroffen. Sowohl der klinische als auch der funktionelle Zustand sind durch Hitzestress eingeschränkt. Ein telemedizinisches Patientenmonitoring senkt das Exazerbationsrisiko und den Bedarf an Krankenversorgung und sollte für das Management von chronischen Erkrankungen während Hitzeperioden zusätzlich zur Grundversorgung bedacht werden.
    No preview · Article · May 2014 · Der Pneumologe
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    ABSTRACT: A home based tele-monitoring system was developed to assess the effects of heat stress (days > 25[degree sign]C) on clinical and functional status in patients with chronic obstructive pulmonary disease (COPD). Sixty-two COPD patients (GOLD II--IV) were randomized into a tele-monitoring Group (TG, N = 32) or Control Group (CG, N = 30). Tele-monitoring included 1) daily clinical status (COPD Assessment Test-CAT), 2) daily lung function and 3) weekly 6-minute walk test (6MWT). Duration of monitoring lasted a total of nine months (9 M). From June 1st--August 31st 2012, 32 days with heat stress (29.0 +/- 2.5[degree sign]C) were recorded and matched with 32 thermal comfort days (21.0 +/- 2.9[degree sign]C). During heat stress, the TG showed a significant reduction in lung function and exercise capacity (FEV1% predicted: 51.1 +/- 7.2 vs. 57.7 +/- 5.0%; P <0.001 and 6MWT performance: 452 +/- 85 vs. 600 +/- 76 steps; P <0.001) and increase in CAT scores (19.2 +/- 7.9 vs. 16.2 +/- 7.2; P <0.001).Over summer, significantly fewer TG patients suffered exacerbation of COPD compared to CG patients (3 vs. 14; P = 0.006). Over entire 9 M follow-up, the TG group had fewer exacerbations compared to CG (7 vs. 22; P = 0.012), shorter cumulative hospital stay (34 vs. 97 days) and 43% fewer specialist consultations (24. vs. 42; P = 0.04). Heat stress affects clinical and functional status in COPD. Tele-monitoring reduces exacerbation frequency and health care utilization during heat stress and other periods of the year.Trial registration: DRKS-ID: DRK00000705.
    Full-text · Article · Nov 2013 · Environmental Health
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    ABSTRACT: Original Investigation SlidePRESENTED ON: Wednesday, October 30, 2013 at 02:45 PM - 03:45 PMPURPOSE: The Lung Volume Reduction Coil (LVRC, PneumRx Inc.) is a bronchoscopic implant for the treatment of severe emphysema, proven to be effective in the treatment of severe COPD. To evaluate longer term efficacy and perform subgroup analyses on efficacy in homogeneous disease, four European studies with nearly identical protocols were analyzed out to one year post-treatment.METHODS: 119 patients (mean age: 61 years, mean FEV1: 29%, mean RV: 245% pred., mean 6MWT 313m) were treated by bilateral LVRC performed in two separate procedures in two contralateral lobes, with follow-up at 6 months and one year. A post-hoc blinded CT analysis was performed on a subset of data I) by a digital lobar CT emphysema score assessing the percentage destruction below -950HU with a <25% difference between ipsilateral lobes defining homogeneous emphysema, and II) by a visual pattern approach grading from 0 (no damage) to 4 (bullous disease) with a difference of ≤1 point defining homogeneous emphysema.RESULTS: 2311 LVRCs were placed in 238 procedures (mean 9.7±1.6 per lobe). Serious adverse events (SAE) in the 30 days following treatment included 13 COPD exacerbations (5.5%), 1 hemoptysis (0.5%), 11 pneumonia (4.6%), 9 pneumothorax (3.8%), no deaths or acute respiratory failure. All SAEs resolved with standard care. Effects of LVRC treatment at 6 and 12 months showed significant and sustained mean efficacy: ΔFEV1: +14.9%±22 and +13.2%±27; ΔRV: -0.59L ±0.76 and -0.52L ±0.77; Δ6MWD: +44m±67 and +51m±62; and ΔSGRQ: -11.2pts±12 and -10pts±12 (p<0.0001 for all values). Post-hoc analysis at 6 months was performed on 63 patients to compare homogeneous and heterogeneous response. Digital CT analyses identified 25 homogenous and 38 heterogeneous cases; the visual approach identified 34 homogeneous and 29 heterogeneous. Both RV, 6MWT and SGRQ responses were similar between the two groups, regardless of the calculation method. Only the FEV1 response differed significantly in favor of the heterogeneous group.CONCLUSIONS: LVRC treatment results in significant and clinically relevant improvements in exercise capacity, lung function, and quality of life for patients with homogeneous and heterogeneous emphysema. Patient relevant improvements from LVRC treatment are sustained at one year.CLINICAL IMPLICATIONS: The Bronchoscopic Lung Volume Reduction Coil Treatment is a feasible, safe and effective treatment modality for patients with severe heterogeneous and homogeneous emphysemaDISCLOSURE: Dirk-Jan Slebos: Consultant fee, speaker bureau, advisory committee, etc.: DJS has been on advisory board meetings of PneumRx and received travel support from PneumRx for presentation of scientific data. The following authors have nothing to disclose: Stephen Bicknell, Wolfgang Gesierich, Felix Herth, Juergen Hetzel, Martin Hetzel, Romain Kessler, Charles-Hugo Marquette, Michel Pfeifer, Pallav Shah, Franz Stanzel, Christian Witt, Gaetan DesleeNo Product/Research Disclosure Information.
    No preview · Article · Oct 2013 · Chest
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    ABSTRACT: Background: Bronchoscopic thermal vapor ablation (BTVA) reduces lung volumes in emphysema patients by inducing a localized inflammatory response (LIR) leading to a healing process of fibrosis, but may also increase symptoms. Objectives: We sought to evaluate whether the clinical manifestation of LIR correlated with patient outcome. Methods: Respiratory adverse events and inflammatory markers were analyzed from a multicenter trial of BTVA in patients with upper-lobe-predominant emphysema. End points including changes in forced expiratory flow (FEV1), lobar volume, St. George's Respiratory Questionnaire (SGRQ), modified Medical Research Council (mMRC) and 6-minute-walk distance (6-MWD) were analyzed according to the presence or absence of a respiratory adverse event requiring treatment with an antibiotic or steroid. Results: Forty-four patients received BTVA. Increases of inflammatory markers were observed with a peak between the second and fourth week. Eighteen respiratory adverse events occurred in 16 patients within 30 days of BTVA, requiring antibiotics and/or steroids. These patients had significantly greater lobar volume reduction (65.3 vs. 33.4%, p = 0.007) and a change in residual volume at 12 months (-933 vs. 13 ml, p < 0.001) associated with a greater improvement of exercise capacity and health-related quality of life than patients without respiratory adverse events. Conclusion: Patients with more prominent respiratory symptoms in the first 30 days following BTVA experience greater efficacy. The clinical manifestations of the LIR are predictive of long-term clinical benefits.
    No preview · Article · Aug 2013 · Respiration

  • No preview · Article · Feb 2013 · Pneumologie

  • No preview · Article · Feb 2013 · Pneumologie

  • No preview · Article · Feb 2013 · Pneumologie
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    ABSTRACT: Background: The prevalence of cardiovascular mortality is high in Chronic Obstructive Pulmonary Disease (COPD) and the identification of clinical parameters to improve risk stratification is of great interest. Objectives: This study aims to assess the predictive strength of daily walking activity on expression of cardiac biomarkers in patients with COPD. Methods: One hundred and five patients with COPD (66.1 ± 8.7 years of age) were prospectively analyzed. Daily walking activity was measured by means of accelerometry. Stepwise multivariate regression analyses were employed with either midregional proatrial natriuretic peptide (MRproANP) or plasma proadrenomedullin (MRproADM) as dependent variables, and age, age-adjusted Charlson score, Modified Medical Research Council Dyspnea Scale (MMRC), Saint Georges Respiratory Questionnaire total score and either total walk, steps per day or fast walk as covariates. Results: Independent predictors of MRproANP included age (p = 0.015) and either total walk or steps per day (both p < 0.0001). Total walk or steps per day were the only independent predictors of MRproADM (p < 0.0001). There was a significant negative correlation between fast walk and MMRC (R = -0.70; p < 0.001) and fast walk was only independently predictive of MRproANP but not MRproADM once MMRC was excluded from the list of covariates (p = 0.023 and p = 0.057, respectively). Conclusions: Daily walking activity independently predicts levels of circulating MRproANP and MRproADM in stable COPD patients, two prognostic biomarkers of cardiac distress associated with long-term survival upon exacerbation of COPD. Employing activity monitors in the stable state might simplify risk stratification in daily living.
    No preview · Article · Dec 2012 · Respiration
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    ABSTRACT: SESSION TYPE: COPD: Therapeutic OptionsPRESENTED ON: Sunday, October 21, 2012 at 10:30 AM - 11:45 AMPURPOSE: Bronchoscopic lung volume reduction is a rapidly developing area and at present intensively evaluated and discussed. The Lung Volume Reduction Coil (RePneu® LVRC, PneumRx Inc.) can be used in patients with severe heterogeneous and homogeneous emphysema, independent of collateral ventilation, due to its mechanical compression of diseased parenchyma. We report on the safety and efficacy of LVR-coil therapy at 12-months post-treatment, from two feasibility studies with nearly identical protocols (NCT01220908, NCT01328899)METHODS: The studies were non-randomized, multicenter and single-arm. 85 patients with severe emphysema were treated with LVR-coils under fluoroscopic guidance, 71 of them bilaterally. Upper and lower lobes were treated. Follow-up included SGRQ, lung function tests and 6MWT. Efficacy was reported for bilaterally-treated patients.RESULTS: In 85 patients (baseline FEV1 29% (±6.4%) predicted), 156 procedures were carried out with, median 10 coils (range 5-15) per procedure. Procedure duration was 48±24 minutes. Serious adverse events possibly related to device or procedure <30 days after treatment were pneumothorax (n=2), pneumonia (n=11), COPD exacerbation (n=10), and hemoptysis (n=2). From 30 days to over 300 days these were: pneumothorax (n=1), dyspnea (n=3), pneumonia (n=10), and COPD exacerbation (n=28). All events resolved with standard care. All efficacy results were reported as change from baseline. At 12 months post-treatment, significant improvements in 6MWT (63.04±13.79 meters), RV (-0.61±0.13 liters), and SGRQ (-12.06±2.43 points) were reported. Overall improvements were sustained relative to the 6-month results.CONCLUSIONS: LVR-coil treatment is an effective technique for endoscopic lung volume reduction, with an acceptable safety profile and sustained benefit. In this cohort of patients with varying degrees of heterogeneity and homogeneity, upper and lower lobe bilateral treatments demonstrate statistically significant and clinically relevant effectiveness at 360 days.CLINICAL IMPLICATIONS: LVR-coil treatment appears to offer an effective treatment for a broad range of emphysema patients. Patients may achieve significant and sustained clinical benefits, and importantly, LVRC treatment appears efficacious in heterogeneous as well as homogeneous disease, in upper as well as lower lobes, and independent of collateral ventilation.DISCLOSURE: The following authors have nothing to disclose: Franz Stanzel, Wolfgang Gesierich, Martin Hetzel, Gaëtan Deslee, Romain Kessler, Christian Witt, Charles Hugo Marquette, Michel Pfeifer, Stefan Blaas, Juergen Hetzel, Felix Herth, Dirk-Jan SlebosPresenter is discussing information about a product which has received CE clearance in the EU, but is NOT approved for sale in the US.Lung Clinic Hemer, Hemer, Germany.
    No preview · Article · Oct 2012 · Chest
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    ABSTRACT: Endoscopic lung volume reduction has been developed as a therapeutic option for advanced emphysema. Six-month results following treatment with endoscopic thermal vapor ablation (InterVapor; Uptake Medical, Tustin, CA) were described previously, and here we report observations from the 12-month assessment. Two multicenter, international, single-arm trials of InterVapor (unilateral upper lobe treatment) in patients with upper lobe predominant emphysema were conducted. Inclusion criteria: forced expiratory volume in 1 second (FEV(1)) 15%-45% predicted, residual volume > 150%, total lung capacity > 100%, 6-minute walk distance (6MWD) > 140 m, and diffusing capacity for carbon monoxide > 20% predicted. Efficacy endpoints: spirometry, body plethysmography, lung volumes by high-resolution computed tomography, St George's Respiratory Questionnaire, modified Medical Research Council dyspnea scale, and 6MWD. All adverse events were collected and independently adjudicated. Forty four patients were treated at a mean (standard deviation) age of 63 (5.6) years, FEV(1) 0.86 mL (0.25 mL) (n = 22 men and 22 women). Mean (standard deviation) changes from baseline at 12 months were: FEV(1) 86.2 mL (173.8 mL), St George's Respiratory Questionnaire -11.0 (14.0) units, treated lobar volume from high-resolution computed tomography -751.8 mL (653.9 mL), residual volume -302.8 mL (775.6 mL), 6MWD 18.5 m (63.7 m), and modified Medical Research Council dyspnea scale score -0.83 (0.97) (P < 0.05 for all except 6MWD). Improvements were numerically larger at 6 versus 12 months. GOLD stage III and IV patients had similar outcomes at 6 months; however, improvements relative to baseline were numerically higher in GOLD stage IV patients. Larger improvements were observed in patients with higher heterogeneity. In total, 39 serious adverse events were reported in 23 patients with 10 events in 8 patients between 6 and 12 months. Unilateral lobar InterVapor treatment of heterogeneous emphysema improved lung function and health outcomes 1 year following treatment. The magnitude of improvement was larger at 6 months compared to 12 months. Improvements relative to baseline continue to be exhibited at 12 months despite the expected disease related decline over time.
    Full-text · Article · Jul 2012 · International Journal of COPD

  • No preview · Conference Paper · May 2012

Publication Stats

3k Citations
503.31 Total Impact Points

Institutions

  • 2003-2015
    • Charité Universitätsmedizin Berlin
      • • Medical Department, Division of Rheumatology and Clinical Immunology
      • • Institute of Medical Informatics
      Berlín, Berlin, Germany
  • 1992-2014
    • Humboldt-Universität zu Berlin
      • • Department of Biology
      • • Clinical Psychology Research Unit
      Berlín, Berlin, Germany
  • 2005
    • Hannover Medical School
      • Centre for Internal Medicine
      Hannover, Lower Saxony, Germany
  • 1996-2005
    • Freie Universität Berlin
      Berlín, Berlin, Germany
  • 2004
    • Humboldt State University
      Arcata, California, United States
  • 2002
    • University of Leipzig
      Leipzig, Saxony, Germany
  • 2000
    • National Heart, Lung, and Blood Institute
      Maryland, United States
  • 1997
    • The Heart Lung Center
      Londinium, England, United Kingdom