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The purpose of the present study is to observe the clinical effect in six-minute walk distance and assess the cardiac function improvement in high thoracic epidural anaesthesia(HTEA)therapy.
52 patients with chronic heart failure all treated with HTEA (these patients from the first affiliated hospital of Harbin medical university), as an conjunctive therapy, and conventional treatment for 4 weeks. The patients were underwent six-minute walk test, echocardiographic, and NYHA class before and after HTEA therapy.
Six-minute walk distance improved from 290.8115±125.24695m to 397.9731±103.15795m(P<0.0001). NYHA class and measurements of echocardiographic also improved significantly. 5 patients treated by four weeks HTEA therapy improved from NYHA class IV to NYHA class I. 13 patients improved from NYHA class IV to NYHA class II, and 10 patients improved from NYHA class III to NYHA class I, 18 patients improved one class. 2 patients have no improvement after HTEA therapy. The date suggested a remarkable improvement in terms of echocardiography. A significant elevation in left ventricular ejection fraction (LVEF) (29.0192±7.22603 vs. 35.9808±7.78706 P<0.0001) was observed in the study, and the reduction in Left ventricular end-diastolic diameter (LVEDd) (68.8519±6.98394mm vs. 66.3846±8.17733mm P<0.0001) and left atrial diameter (LAD) (52.4040±8.16098 vs. 49.2600±8.00207mm P<0.0001) were also observed. After 4 weeks treatment, the NT-proBNP levels significantly decreased from 6845.8090±22199.3155 to 1755.0288±2443.30776pg/ml (P<0.0001).
HTEA could significantly elevate six-minute walk distance, improve cardiac function, decrease the NT-proBNP level, improve quality of life, increase daily living activities, and improve heart failure symptom. HTEA is a safe and effective therapy.