Question on CHF and Exercise
Larry
LVEF is 35%. Is it possible for regular exercise (aerobic as in
treadmill) to improve that LVEF?
Larry E.
Andrew B. Chung, MD/PhD
Regular exercise has not been shown in RCTs to improve LVEF in folks
with cardiomyopathy as a consequence of valvular heart disease.
It is likely the problems with the pulmonic and tricuspid valves are
secondary to the mitral regurgitation so that if the mitral valve were
either repaired or replaced that your dad would no longer have the TR
and PI. However, LVEF is typically less after such corrective surgery
so that many would regard your dad's condition as end-stage.
Would suggest you have your dad ask his cardiologist about referring
him for EECP if there are no contraindications in order to possibly
normalize his LVEF so that he would possibly be a candidate for MV
surgery.
Be hungry... be healthy... be hungrier... be blessed:
http://TheWellnessFoundation.com/BeHealthy
Prayerfully in the infinite power and might of the Holy Spirit,
Andrew <><
--
Andrew B. Chung, MD/PhD
Lawful steward of http://EmoryCardiology.com
Swordbearer for the KING of kings and LORD of lords.
http://HeartMDPhD.com/Sword
Larry
repair/replacement for tricuspid or mitral valve regurgitation. I don't
understand this, unless he feels that he would be a poor risk at 86 y/o
with 35% LVEF. I have never heard of EECP but will do some research and
see if it makes sense to bring that up. I guess the bottom line question
is ... what is his life expectancy being treated with drugs for the CHF
vs. the risk of valve replacement surgery and how long that would
prolong his life.
Thanks again for your help.
Larry E.
Andrew B. Chung, MD/PhD
> Andrew, in the Holy Spirit, boldly wrote:
> > Larry wrote:
> >
> >>My Dad has CHF caused by mitral, tricuspid, and pulmonary regurgitation.
> >>LVEF is 35%. Is it possible for regular exercise (aerobic as in
> >>treadmill) to improve that LVEF?
> >
> > Regular exercise has not been shown in RCTs to improve LVEF in folks
> > with cardiomyopathy as a consequence of valvular heart disease.
> >
> > It is likely the problems with the pulmonic and tricuspid valves are
> > secondary to the mitral regurgitation so that if the mitral valve were
> > either repaired or replaced that your dad would no longer have the TR
> > and PI. However, LVEF is typically less after such corrective surgery
> > so that many would regard your dad's condition as end-stage.
> >
> > Would suggest you have your dad ask his cardiologist about referring
> > him for EECP if there are no contraindications in order to possibly
> > normalize his LVEF so that he would possibly be a candidate for MV
> > surgery.
> >
> repair/replacement for tricuspid or mitral valve regurgitation.
That would be correct for the tricuspid valve but not correct for the
mitral valve.
> I don't
> understand this, unless he feels that he would be a poor risk at 86 y/o
> with 35% LVEF.
Both the age and the diminished LVEF increase the risk of poor
outcomes.
> I have never heard of EECP but will do some research and
> see if it makes sense to bring that up. I guess the bottom line question
> is ... what is his life expectancy being treated with drugs for the CHF
> vs. the risk of valve replacement surgery and how long that would
> prolong his life.
With a current LVEF of 35%, mitral valve surgery will likely shorten
rather than extend life especially for elderly folks (age > 80
years).
> Thanks again for your help.
Laus Deo
Be hungry... be healthy... be hungrier... be blessed:
http://TheWellnessFoundation.com/BeHealthy
Prayerfully in the infinite power and might of the Holy Spirit,
Andrew <><
--
Andrew B. Chung, MD/PhD
Lawful steward of http://EmoryCardiology.com
Swordbearer for the KING of kings and LORD of lords.
http://HeartMDPhD.com/Sword
> Larry E.
Larry
mildly enlarged, right atrium moderately enlarged, right ventricle
moderately enlarged with RVSP 36.4mm.
This change anything?
Larry E.
Andrew B. Chung, MD/PhD
It allows me to predict that your dad's heart rate tends to be high
(>90) and that he tends to be short of breath at night especially when
lying flat and also when exerting himself.
Larry
pacemaker for Atrial Fib and is on Tenormin). I know that because he
just had hernia surgery and I watched the monitor pretty closely. Short
of breath? Has some of that ... but not serious yet ... certainly not
when lying flat. Perhaps cause of the med. Thanks.
Larry E.
Andrew B. Chung, MD/PhD
> pacemaker for Atrial Fib and is on Tenormin).
That would likely be the rate set on his pacemaker.
> I know that because he
> just had hernia surgery and I watched the monitor pretty closely. Short
> of breath? Has some of that ... but not serious yet ... certainly not
> when lying flat. Perhaps cause of the med.
Medical therapy can be efficacious.
> Thanks.
Laus Deo: