Table 3.
The effects of thoracic epidural anesthesia and exercise on systolic and diastolic left ventricular function
| Conditions | Rest | Exercise stages | Effects | |||||
|---|---|---|---|---|---|---|---|---|
| T0 | T1 | T2 | T3 | TEA | Exercise | Interaction | ||
| Systolic function | ||||||||
| MV Sʹ (cm/s) |
Control TEA |
10.8 (2.7) 10.6 (2.2) |
13.0 (3.3) 12.4 (3.5) |
16.1 (4.4) 13.8 (5.0) |
16.9 (5.3) 15.7 (5.1) |
P = 0.025 | P < 0.001 | P = 0.302 |
| Diastolic function | ||||||||
| MV Eʹ (cm/s) |
Control TEA |
14.0 (4.0) 13.4 (4.1) |
16.1 (3.3) 15.0 (3.3) |
17.2 (4.3) 16.3 (3.0) |
17.9 (4.3) 17.4 (4.1) |
P = 0.470 | P < 0.001 | P = 0.956 |
| MV Aʹ (cm/s) |
Control TEA |
8.6 (3.3) 8.3 (3.6) |
10.3 (4.2) 10.2 (3.7) |
12.7 (3.2) 10.3 (4.6) |
12.7 (4.2) 14.8 (6.3) |
P = 0.230 | P < 0.001 | P = 0.138 |
| MV E (m/s) |
Control TEA |
0.76 (0.17) 0.76 (0.13) |
0.89 (0.14) 0.87 (0.11) |
0.98 (0.15) 0.96 (0.16) |
1.09 (0.22) 1.13 (0.14) |
P = 0.836 | P < 0.001 | P = 0.724 |
| MV Dec T (ms) |
Control TEA |
169 (41) 186 (30) |
178 (33) 153 (27) |
163 (33) 139 (33) |
134 (25) 141 (36) |
P = 0.056 | P < 0.001 | P = 0.035 |
| MV A (m/s) |
Control TEA |
0.64 (0.19) 0.55 (0.18) |
0.74 (0.13) 0.68 (0.17) |
0.81 (0.18) 0.72 (0.23) |
0.85 (0.24) 0.81 (0.25) |
P = 0.172 | P < 0.001 | P = 0.922 |
| MV E/A |
Control TEA |
1.3 (0.36) 1.5 (0.54) |
1.2 (0.35) 1.4 (0.33) |
1.3 (0.29) 1.3 (0.32) |
1.3 (0.42) 1.6 (0.64) |
P = 0.039 | P = 0.159 | P = 0.701 |
| MV E/Eʹ |
Control TEA |
5.6 (1.2) 6.0 (1.5) |
5.7 (1.0) 6.0 (1.2) |
6.0 (1.6) 6.0 (1.2) |
6.0 (1.6) 6.7 (1.1) |
P = 0.233 | P < 0.001 | P = 0.744 |
| MV Eʹ/Aʹ |
Control TEA |
1.9 (1.0) 2.0 (1.2) |
1.8 (0.6) 1.7 (0.8) |
1.5 (0.6) 2.0 (1.1) |
1.6 (0.8) 1.4 (0.7) |
P = 0.345 | P = 0.073 | P = 0.231 |
Values at rest and during exercise are presented as mean (SD). Effects were determined by a linear mixed effects model (see Data analysis for details) and presented as P value. T0, 30 min after epidural injection of ropivacaine 0,75%/ NaCl 0,9%; T1, after 3 min bicycling with 20% of maximal workload; T2, after 3 min bicycling with 40% of maximal workload; T3, after 3 min bicycling with 60% of maximal workload
TEA thoracic epidural anesthesia, MV Sʹ peak systolic velocity of the mitral annulus, MV Eʹ early diastolic velocity of the mitral annulus, MV Aʹ late diastolic velocity of the mitral annulus, MV E peak mitral flow velocity during early filling phase, MV Dec T the time interval required for the E velocity to decline from its peak to the baseline, MV A peak mitral flow velocity during atrial contraction phase, MV E/A ratio of E to A, MV E/Eʹ ratio E to Eʹ, MV Eʹ/Aʹ the ratio of Eʹ to Aʹ