Related Experiment Video
Updated: Jun 23, 2026

Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine
Published on: July 7, 2016
High thoracic epidural analgesia improves left ventricular function in patients with ischemic heart
C-J Jakobsen1, E Nygaard, K Norrild
1Department of Anaesthesia & Intensive Care, Aarhus University Hospital, Skejby, Aarhus, Denmark. cjj@dadlnet.dk
Background:
In patients with ischemic heart disease, high thoracic epidural analgesia (HTEA) has been proposed to improve myocardial function. Tissue Doppler Imaging (TDI) is a tool for quantitative determination of myocardial systolic and diastolic velocities and a derivative of TDI is tissue tracking (TT), which allows quantitative assessment of myocardial systolic longitudinal displacement during systole. The purpose of this study was to evaluate the effect of thoracic epidural analgesia on left ventricular (LV) systolic and diastolic function by means of two-dimensional (2D) echocardiography and TDI in patients with ischemic heart disease.
Methods:
The effect of a high epidural block (at least Th1-Th5) on myocardial function in patients (N=15) with ischemic heart disease was evaluated. Simpson's 2D volumetric method was used to quantify LV volume and ejection fraction. Systolic longitudinal displacement was assessed by the TT score index and the diastolic function was evaluated from changes in early (E'') and atrial (A'') peak velocities during diastole.
Results:
After HTEA, 2D measures of left ventricle function improved significantly together with the mean TT score index [from 5.87 +/- 1.53 to 6.86 +/- 1.38 (P<0.0003)], reflecting an increase in LV global systolic function and longitudinal systolic displacement. The E''/A'' ratio increased from 0.75 +/- 0.27 to 1.09 +/- 0.32 (P=0.0026), indicating improved relaxation.
Conclusion:
A 2D-echocardiography in combination with TDI indicates both improved systolic and diastolic function after HTEA in patients with ischemic heart disease.
Related Concept Videos
Cardiomyopathy V: Interprofessional Care
Cardiac Catheterization III: Left Heart Catheterization
Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion, evaluates...
Cardiomyopathy III: Hypertrophic Cardiomyopathy
Heart Failure VI: Adjunct Therapies
Cardiomyopathy II: Dilated Cardiomyopathy
