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Physiological Modeling of Responses to Upper Versus Lower Lobe Lung Volume Reduction in Homogeneous Emphysema

Overview of attention for article published in Frontiers in Physiology, January 2012
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Title
Physiological Modeling of Responses to Upper Versus Lower Lobe Lung Volume Reduction in Homogeneous Emphysema
Published in
Frontiers in Physiology, January 2012
DOI 10.3389/fphys.2012.00387
Pubmed ID
Authors

Arschang Valipour, Mordechai R. Kramer, Franz Stanzel, Axel Kempa, Sherwin Asadi, Oren Fruchter, Ralf Eberhardt, Felix J. Herth, Edward P. Ingenito

Abstract

Rationale: In clinical trials, homogeneous emphysema patients have responded well to upper lobe volume reduction but not lower lobe volume reduction. Materials/Methods: To understand the physiological basis for this observation, a computer model was developed to simulate the effects of upper and lower lobe lung volume reduction on RV/TLC and lung recoil in homogeneous emphysema. Results: Patients with homogeneous emphysema received either upper or lower lobe volume reduction therapy based on findings of radionucleotide scintigraphy scanning. CT analysis of lobar volumes showed that patients undergoing upper (n = 18; -265 mL/site) and lower lobe treatment (LLT; n = 11; -217 mL/site) experienced similar reductions in lung volume. However, only upper lobe treatment (ULT) improved FEV(1) (+11.1 ± 14.7 versus -4.4 ± 15.8%) and RV/TLC (-5.4 ± 8.1 versus -2.4 ± 8.6%). Model simulations provided an unexpected explanation for this response. Increases in transpulmonary pressure subsequent to volume reduction increased RV/TLC in upper lobe alveoli, while caudal shifts in airway closure decreased RV/TLC in lower lobe alveoli. ULT, which eliminates apical alveoli with high RV/TLC values, lowers the average RV/TLC of the lung. Conversely, LLT, which eliminates caudal alveoli with low RV/TLC values, has less effect. Conclusion: LLT in homogeneous emphysema is uniformly less effective than ULT.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 22 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 22 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 6 27%
Other 3 14%
Student > Ph. D. Student 3 14%
Student > Doctoral Student 2 9%
Professor 2 9%
Other 4 18%
Unknown 2 9%
Readers by discipline Count As %
Medicine and Dentistry 9 41%
Engineering 3 14%
Agricultural and Biological Sciences 2 9%
Computer Science 2 9%
Chemical Engineering 1 5%
Other 3 14%
Unknown 2 9%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 October 2012.
All research outputs
#20,167,959
of 22,679,690 outputs
Outputs from Frontiers in Physiology
#9,273
of 13,472 outputs
Outputs of similar age
#221,189
of 244,102 outputs
Outputs of similar age from Frontiers in Physiology
#208
of 309 outputs
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