Effects of thoracic epidural blockade on mortality of patients with idiopathic dilated cardiomyopathy and heart failure

Effect of High Thoracic Sympathetic Nerve Block on Serum Collagen Biomarkers in Patients with Chronic Heart Failure

“…We proved that HTSB improved myocardial remodelling and dysfunction in HF. These results are consistent with previous research [14,15]. Due to the unique effects of sympathetic blockade, HTSB induced vasodilation and reduced heart rate in patients with HF to reduce cardiac workload.…”

“…Long-term HTSB therapy can continuously reduce sympathetic drive in the heart and peripheral vessels in the upper chest in HF patients. Hence, HTSB has been used to treat patients with chronic HF [14,15]. However, the impact of HTSB therapy on myocardial fibrosis in HF is unclear.…”

Effects of Thoracic Epidural Anesthesia on Cardiac Function and Myocardial Cell Apoptosis in Isoproterenol‐Induced Chronic Heart Failure Rats

“…In recent years, growing consensus, driven by both clinical and laboratory studies, has demonstrated that TEA could decrease heart rate, systemic vascular resistance, and the size of myocardial infarction, improving cardiac function, and increasing endocardial‐to‐epicardial blood flow in the heart. In this way, it reduces the re‐hospitalization and mortality rates in CHF patients . Most importantly, TEA has been demonstrated to block cardiac primary afferents and cardiac sympathetic efferent nerves.…”

“…Most importantly, TEA has been demonstrated to block cardiac primary afferents and cardiac sympathetic efferent nerves. It then blocks the cardiac stress neural reflex and attenuates norepinephrine spilloverin myocardium evoked by acute myocardial ischemia, which could greatly contribute to reduction in apoptosis of myocardium . Furthermore, there is evidence to suggest that TEA could up‐regulate anti‐apoptotic proteins, such as bcl‐2, and inhibit the release of mitochondrial cytochrome C and other apoptosis inducing factors .…”

“…Based on the above, it is reasonable to postulate that TEA may reduce cardiomyocyte apoptosis through modulation of the neural mechanisms and apoptosis‐related gene expression. Consequently, TEA may significantly improve cardiac function in patients with CHF . To further test this hypothesis, the following study was carried out on a rat model of CHF to clarify the molecular mechanisms underlying TEA's cardio‐protective effects and its clinical therapeutic application for CHF, as well as to identify ways of preventing and treating CHF.…”