PMID- 28826849
OWN - NLM
STAT- MEDLINE
DCOM- 20180604
LR  - 20180604
IS  - 1532-8422 (Electronic)
IS  - 1053-0770 (Linking)
VI  - 31
IP  - 5
DP  - 2017 Oct
TI  - Thoracic Epidural Anesthesia Reversed Myocardial Fibrosis in Patients With Heart 
      Failure Caused by Dilated Cardiomyopathy.
PG  - 1672-1675
LID - S1053-0770(17)30492-5 [pii]
LID - 10.1053/j.jvca.2017.05.014 [doi]
AB  - OBJECTIVE: To verify that high thoracic epidural anesthesia (TEA) could reverse 
      myocardial fibrosis in heart failure caused by dilated cardiomyopathy (DCM). 
      DESIGN: Hospitalized patients with DCM and heart failure. SETTING: Harbin Medical 
      University, Harbin, Heilongjiang, China. PARTICIPANTS: Eight patients. 
      INTERVENTIONS: 0.5% lidocaine was administered epidurally at the T4-T5 interspace 
      for 4 weeks. MEASUREMENTS AND MAIN RESULTS: Eight hospitalized patients with DCM 
      and heart failure were enrolled into the present study. All patients received TEA 
      plus optimal medical therapy (OMT) for 4 weeks. Echocardiograms and cardiac 
      magnetic resonance (CMR) with late gadolinium enhancement (LGE) technique were 
      used to evaluate cardiac function and detect myocardial fibrosis before and after 
      treatment. The 6-minute walking distance and the level of N-terminal pro-B-type 
      natriuretic peptide (NT-proBNP) also were measured. The authors used before-after 
      study to verify whether thoracic epidural anesthesia could reverse myocardial 
      fibrosis. The left ventricular end-diastolic diameter was reduced significantly 
      and the left ventricular ejection fraction (LVEF) was increased significantly 
      after a 4-week treatment. Meanwhile, the 6-minute walking distance was increased 
      dramatically. Furthermore, the level of NT-proBNP was reduced significantly after 
      TEA plus OMT treatment. Consistent with echocardiography parameters, the LVEF 
      measured by CMR also was increased markedly. Both total LGE volume and average 
      LGE volume were reduced significantly after 4 weeks of TEA plus OMT treatment. 
      CONCLUSIONS: TEA plus OMT could reverse myocardial fibrosis and improve cardiac 
      function in patients with heart failure caused by DCM.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Ma, Dan
AU  - Ma D
AD  - Department of Internal Intensive Medicine, the First Affiliated Hospital, Harbin 
      Medical University, Harbin, China.
FAU - Liu, Lei
AU  - Liu L
AD  - Department of Internal Intensive Medicine, the First Affiliated Hospital, Harbin 
      Medical University, Harbin, China.
FAU - Zhao, Hongwei
AU  - Zhao H
AD  - Department of Internal Intensive Medicine, the First Affiliated Hospital, Harbin 
      Medical University, Harbin, China.
FAU - Zhang, Ruiying
AU  - Zhang R
AD  - Department of Internal Intensive Medicine, the First Affiliated Hospital, Harbin 
      Medical University, Harbin, China.
FAU - Yun, Fengxiang
AU  - Yun F
AD  - Department of Internal Intensive Medicine, the First Affiliated Hospital, Harbin 
      Medical University, Harbin, China.
FAU - Li, Lulu
AU  - Li L
AD  - Department of Magnetic Resonance Imaging (MRI), the First Affiliated Hospital, 
      Harbin Medical University, Harbin, China.
FAU - Wang, Yang
AU  - Wang Y
AD  - Department of Magnetic Resonance Imaging (MRI), the First Affiliated Hospital, 
      Harbin Medical University, Harbin, China.
FAU - Qu, Renhai
AU  - Qu R
AD  - Department of Anesthesiology, the First Affiliated Hospital, Harbin Medical 
      University, Harbin, China.
FAU - Liu, Pengfei
AU  - Liu P
AD  - Department of Magnetic Resonance Imaging (MRI), the First Affiliated Hospital, 
      Harbin Medical University, Harbin, China.
FAU - Liu, Fengqi
AU  - Liu F
AD  - Department of Internal Intensive Medicine, the First Affiliated Hospital, Harbin 
      Medical University, Harbin, China. Electronic address: fengqiliu1964@163.com.
LA  - eng
PT  - Journal Article
DEP - 20170504
PL  - United States
TA  - J Cardiothorac Vasc Anesth
JT  - Journal of cardiothoracic and vascular anesthesia
JID - 9110208
RN  - 0 (Anesthetics, Local)
RN  - 98PI200987 (Lidocaine)
SB  - IM
MH  - Aged
MH  - Anesthesia, Epidural/*methods/trends
MH  - Anesthetics, Local/administration & dosage
MH  - Cardiomyopathy, Dilated/complications/*diagnostic imaging/*physiopathology
MH  - Cohort Studies
MH  - Female
MH  - Fibrosis
MH  - Heart Failure/*diagnostic imaging/etiology/*physiopathology
MH  - Humans
MH  - Lidocaine/administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Thoracic Vertebrae
OTO - NOTNLM
OT  - dilated cardiomyopathy
OT  - heart failure
OT  - late gadolinium enhancement
OT  - myocardial fibrosis
OT  - thoracic epidural anesthesia
EDAT- 2017/08/23 06:00
MHDA- 2018/06/05 06:00
CRDT- 2017/08/23 06:00
PHST- 2016/12/25 00:00 [received]
PHST- 2017/08/23 06:00 [pubmed]
PHST- 2018/06/05 06:00 [medline]
PHST- 2017/08/23 06:00 [entrez]
AID - S1053-0770(17)30492-5 [pii]
AID - 10.1053/j.jvca.2017.05.014 [doi]
PST - ppublish
SO  - J Cardiothorac Vasc Anesth. 2017 Oct;31(5):1672-1675. doi: 
      10.1053/j.jvca.2017.05.014. Epub 2017 May 4.