title: Effect of thoracic epidural blockade on plasma fibrinogen levels in patients with dilated cardiomyopathy.
abstract: OBJECTIVE
  To investigate the effects of thoracic epidural blockade (TEB) on plasma fibrinogen (FIB) levels.
  
  
  METHODS
  Thirty cases of dilated cardiomyopathy (DCM) were selected randomly into a TEB group and a control group. TEB patients were subjected to a persistent TEB (T1 - 5), and injected with 0.5% lidocaine 3 - 5 ml every two or four hours for four weeks in addition to routine medicine, while patients in the control group were given routine medicine only. Plasma concentrations of FIB were measured using the micro-capillary assay. Doppler echocardiography was performed before and after the treatment.
  
  
  RESULTS
  Plasma concentrations of FIB in two groups were greater than the normal value before the treatment. There was a significant decrease of plasma concentrations of FIB in the TEB group after the treatment (4.2 +/- 1.3 g/L vs 3.6 +/- 0.9 g/L, P < 0.05), but there was no significant change in the control group (4.2 +/- 1.2 g/L vs 4.3 +/- 1.9 g/L, P > 0.05). After four weeks of treatment, the left ventricular end diastolic diameters (LVEDD) of TEB patients were reduced (72 +/- 10 mm vs 69 +/- 10 mm, P < 0.05) and the left ventricular ejection fraction (LVEF) of TEB patients increased significantly (33% +/- 13% vs 44% +/- 14%, P < 0.05). In contrast, LVEDD (73 +/- 11 mm vs 73 +/- 12 mm, P > 0.05) and LVEF (32% +/- 14% vs 33% +/- 12%, P > 0.05) did not change significantly in the control group.
  
  
  CONCLUSIONS
  The results suggest that plasma FIB levels in patients with DCM were decreased by performing a TEB, in addition to a reduction of the enlarged cardiac cavity and an improvement in cardiac systolic dysfunction. TEB might contribute to lowering the occurrence of thrombus and thromboembolism in patients with DCM. TEB might be a promising therapeutic method to improve the prognosis of DCM patients.
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China.
authors.forename: Zhuqin
authors.initials: Z
authors.lastname: Li
authors.forename: Fengqi
authors.initials: F
authors.lastname: Liu
authors.forename: Shiying
authors.initials: S
authors.lastname: Fu
authors.forename: Renhai
authors.initials: R
authors.lastname: Qu
authors.forename: Zhixiang
authors.initials: Z
authors.lastname: Liu
authors.forename: Shuliang
authors.initials: S
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural; D001340:Autonomic Nerve Block; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000628:therapy*; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D005340:Fibrinogen