OBJECTIVETo investigate the effects of thoracic epidural blockade (TEB) on plasma fibrinogen (FIB) levels.

METHODSThirty 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.

RESULTSPlasma 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.

CONCLUSIONSThe 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.