title: Effect of High Thoracic Sympathetic Nerve Block on Serum Collagen Biomarkers in Patients with Chronic Heart Failure.
abstract: OBJECTIVE
  The impact of high thoracic sympathetic block (HTSB) on myocardial fibrosis in chronic heart failure (HF) is unclear. Myocardial collagen synthesis can be assessed by measuring circulating biomarkers. We observed the effect of HTSB on serum collagen biomarkers in HF.
  
  
  METHODS
  Forty-four patients were randomized to a control and a HTSB group. They received routine medications. Repeated epidural injections were given to the HTSB group for 4 weeks. Echocardiography and measurements of serum carboxy-terminal propeptide of procollagen type I (PICP) and amino-terminal propeptide of procollagen type III (PIIINP) were performed at baseline and 4 weeks later.
  
  
  RESULTS
  There were significant reductions in left atrial diameter, left ventricular (LV) diameter and volume, LV weight index (LVWI) and serum PICP and PIIINP levels in the HTSB group (p < 0.05). The changes in LV end-systolic volume and ejection fraction (LVEF) were greater in the HTSB group than in the control group (p < 0.05). In the HTSB group, the decreases in PICP and PIIINP were correlated with the decrease in LVWI (PICP: r = 0.695, p = 0.000; PIIINP: r = 0.642, p = 0.001), and the decrease in PICP was negatively associated with the rise in LVEF (r = -0.813, p = 0.000).
  
  
  CONCLUSIONS
  HTSB reduces myocardial fibrosis in HF, which may accompany the improvement of LV hypertrophy and dysfunction.
authors: Department of Internal Intensive Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
authors: Guifang
authors: G
authors: Sun
authors: Fengqi
authors: F
authors: Liu
authors: Renhai
authors: R
authors: Qu
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001340:Autonomic Nerve Block; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D003094:Collagen / Q000097:blood*; D005355:Fibrosis; D006333:Heart Failure / Q000097:blood / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D010446:Peptide Fragments / Q000097:blood; D011347:Procollagen / Q000097:blood
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide; C042813:procollagen type I carboxy terminal peptide; D003094:Collagen