1. < Heart & Blood Health

LVEF

Posted by wangs @wangs, Apr 24, 2018

I recently did three test to check my LVEF, they were respectively 50%,43% (Echo) and 25% (cardiac MRI). I do not know which one I should believe.

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wangs | @wangs | Apr 24, 2018

Or is there other way to verify them?

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drtapasgoswami | @drtapasgoswami | Apr 24, 2018

It's worrisome. Repeat Echo.

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Kanaaz Pereira, Connect Moderator | @kanaazpereira | Apr 25, 2018

Hi @wangs,

Here are some guidelines from the American Heart Association with regard to LVEF assessment:
- http://www.heart.org/HEARTORG/Conditions/HeartFailure/DiagnosingHeartFailure/Ejection-Fraction-Heart-Failure-Measurement_UCM_306339_Article.jsp#.WuCKEi_MxQY

According to Mayo Clinic: "Experts vary in their opinions about an LV ejection fraction between 50 and 55 percent, and some would consider this a "borderline" range. Keep in mind that ejection fraction is just one measure of heart function. Even with a normal ejection fraction, overall heart function may not be normal." https://www.mayoclinic.org/ejection-fraction/expert-answers/faq-20058286

I'd like to invite Connect Mentors @hopeful33250 and @predictable to weigh in, as well. @wangs, have you shared your concerns with your cardiologist?

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Mentor
Teresa, Volunteer Mentor | @hopeful33250 | Apr 25, 2018

Hello @wangs

I appreciate your question regarding the changes in your EF which seems to vary from test to test. I'm glad that @kanaazpereira invited me into this conversation. If I may ask, was there a long time period between these different tests, or were they done within a similar time frame?

I have a relatively good EF (60) at last echo, however, my heart function is not completely OK. I do have diastolic dysfunction (mild form of heart failure) and a recent echo also showed an additional diagnosis of mild hypokinesis of the entire apical wall which indicates a lessening of the function of the heart muscle. As I do have symptoms of fatigue and some breathing problems upon exercise this becomes a concern.

If you care to share more, could you please share what symptoms you may be having now and/or how they have changed over time? I ask this because my general cardiologist always states that he does not treat the test results, but he treats the patient. By this I believe he means that if you have symptoms it is good to look for something that can be done.

I look forward to hearing from you again.

Teresa

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wangs | @wangs | Apr 25, 2018

Thanks both of you to share your experience and knowledge. the three tests were done through two month period. I do have similar situation like Teresa has. But they are also a little different. I had a heart attack twenty three years ago. I had a thrombus in my LV since then. I had done tons echo and other tests, non of the findings were lower than 30%. Actually I have charted them, the trend is getting better. I do not know why the last three tests had so much different findings. Meanwhile I have a few typical symptoms like most patient have. such as short breathe( very miner), fatigue( Yes I do have it, but considering my age, it can be expected), no swell on my ankles, I do not need high pillows.. I swim three times each week, every time I swim 60 min. about 1500m cumulatively. I do not know what I should do about it.
By the way I just got a call from my cardiologist who suggested me to do MUCA test. He does not believe the reading doctor's findings from MRI. He said that there are lots human being factors involved.
I wonder which class medications are better drugs to improve LVEF.

Shousan Wang

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3 replies
Mentor
Teresa, Volunteer Mentor | @hopeful33250 | Apr 25, 2018
In reply to @wangs "Thanks both of you to share your experience and knowledge. the three tests were done through..." + (show)
@wangs

Thanks both of you to share your experience and knowledge. the three tests were done through two month period. I do have similar situation like Teresa has. But they are also a little different. I had a heart attack twenty three years ago. I had a thrombus in my LV since then. I had done tons echo and other tests, non of the findings were lower than 30%. Actually I have charted them, the trend is getting better. I do not know why the last three tests had so much different findings. Meanwhile I have a few typical symptoms like most patient have. such as short breathe( very miner), fatigue( Yes I do have it, but considering my age, it can be expected), no swell on my ankles, I do not need high pillows.. I swim three times each week, every time I swim 60 min. about 1500m cumulatively. I do not know what I should do about it.
By the way I just got a call from my cardiologist who suggested me to do MUCA test. He does not believe the reading doctor's findings from MRI. He said that there are lots human being factors involved.
I wonder which class medications are better drugs to improve LVEF.

Shousan Wang

Jump to this post

@wangs Hello Shousan:

I appreciate you sharing some more of your history of heart problems. You were wondering about what class of drugs are better to improve LVEF. Could you share with us what type of drugs you are currently taking?

As your cardiologist mentioned the MUGA test, I found a link on Mayo's website regarding this test, https://www.mayoclinic.org/departments-centers/cardiovascular-medicine/overview/specialty-groups/nuclear-cardiology-laboratory/overview.

I hope that you are able to find answers through this test and feel confident that you are doing as much as you can to treat this situation.

I look forward to hearing from you again.

Teresa

REPLY
Martin Jensen, Volunteer Mentor | @predictable | Apr 25, 2018
In reply to @wangs "Thanks both of you to share your experience and knowledge. the three tests were done through..." + (show)
@wangs

Thanks both of you to share your experience and knowledge. the three tests were done through two month period. I do have similar situation like Teresa has. But they are also a little different. I had a heart attack twenty three years ago. I had a thrombus in my LV since then. I had done tons echo and other tests, non of the findings were lower than 30%. Actually I have charted them, the trend is getting better. I do not know why the last three tests had so much different findings. Meanwhile I have a few typical symptoms like most patient have. such as short breathe( very miner), fatigue( Yes I do have it, but considering my age, it can be expected), no swell on my ankles, I do not need high pillows.. I swim three times each week, every time I swim 60 min. about 1500m cumulatively. I do not know what I should do about it.
By the way I just got a call from my cardiologist who suggested me to do MUCA test. He does not believe the reading doctor's findings from MRI. He said that there are lots human being factors involved.
I wonder which class medications are better drugs to improve LVEF.

Shousan Wang

Jump to this post

Hi @wangs. Glad to have this chance to make your acquaintance and give you my best wishes for getting on top of your LV challenge. Quite by coincidence, I ran across some information from the American Heart Association just this morning that you may find useful. It focuses on the MUGA test on one page and more generally Ejection Fractions on the other. Here are the links:
http://www.heart.org/HEARTORG/Conditions/HeartFailure/SymptomsDiagnosisofHeartFailure/Ejection-Fraction-Heart-Failure-Measurement_UCM_306339_Article.jsphttp://www.heart.org/HEARTORG/Conditions/HeartAttack/DiagnosingaHeartAttack/Radionuclide-Ventriculography-or-Radionuclide-Angiography-MUGA-Scan_UCM_446354_Article.jsp
From this and other literature, it seems clear to me that the percentage numbers of Ejection Fractions can be misleading if they are read without professional interpretation by the doctors who performed the tests. The numbers seem to jump around, but that's because they means something a little different from person to person, from test to test, and from cause to cause. I hope you'll have a chance for confidence about the information your doctors are providing.

Martin

REPLY
wangs | @wangs | Apr 25, 2018
In reply to @wangs "Thanks both of you to share your experience and knowledge. the three tests were done through..." + (show)
@wangs

Thanks both of you to share your experience and knowledge. the three tests were done through two month period. I do have similar situation like Teresa has. But they are also a little different. I had a heart attack twenty three years ago. I had a thrombus in my LV since then. I had done tons echo and other tests, non of the findings were lower than 30%. Actually I have charted them, the trend is getting better. I do not know why the last three tests had so much different findings. Meanwhile I have a few typical symptoms like most patient have. such as short breathe( very miner), fatigue( Yes I do have it, but considering my age, it can be expected), no swell on my ankles, I do not need high pillows.. I swim three times each week, every time I swim 60 min. about 1500m cumulatively. I do not know what I should do about it.
By the way I just got a call from my cardiologist who suggested me to do MUCA test. He does not believe the reading doctor's findings from MRI. He said that there are lots human being factors involved.
I wonder which class medications are better drugs to improve LVEF.

Shousan Wang

Jump to this post

Hi, Teresa,
Currently I am taking,
1. RANEXA ER
2. FENOFIBRATE
3. ENTRESTO
4. WARFARIN SODIUM
5. ATORVASTATIN
6. BYSTOLIC
7. HYDRALAZINE
8. ISOSORBIDEMN ER
9. EZETIMIBE

I do not know if there are other drugs to help improving LVEF.
thanks,
Shousan

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