Can we talk Ejection Fraction ??? A few questions

Valve Replacement Forums

Help Support Valve Replacement Forums:

This site may earn a commission from merchant affiliate links, including eBay, Amazon, and others.

Roxx_yer_Soxx

Well-known member
Joined
Dec 8, 2009
Messages
62
Location
Lima, Ohio
Ok, so in the "heart talk" section here I would like to post a topic on EF.

On my ECHO from June 2009, EF was estimated at 66%
On my Echo from Sept. 2010, EF was right at 50%

This concerns me.....

1) In that year, I have UPPED my cardio amount, running several miles a week.
2) In that year, I cut my salt intake to almost nothing

Some facts:
1) Since that 1st Echo, I have taken 10mg of Lexapro everyday (makes me mellow)
2) At the 1st Echo, I was about a 8 on a 10 scale of panic attack (reason why I take Lexapro) verrry nervous...thought i was going to have to stop the study.
3) At the Sept. 2010... I was very calm, very mellow, and relaxed......about fell asleep during the Echo....literally.

My questions:

Does EF fluctuate throughout the day just as blood pressure does?
I am strongly considering doing another ECHO again in the next few weeks just to see what happens...... possibly even skipping Lexapro that day so I am keyed up...... I would rather been nervous than lose 16% HEART function.
 
Good Questions to ask your Cardiologist.

Note the Keyword in your first report: Estimated

Echo Data is Highly Dependent on the Technician's interpretation and experience,
especially for parameters that are "estimated"!

It wouldn't hurt to have another echo performed and to ask your Cardio for his estimate after reviewing the tape.

'AL Capshaw'
 
Al- The report doesn't say estimated...that was a word i used.

09 says 66%
10 says 50%

My main question is, if i am sitting here doing nothing...... or if I get up and sprint to the end of the block, does my EF stay the same?
I would guess NOT.

If I get up and run, my pulse goes up, my heart rate goes up, and breathing increases..... my guess would be EF increases during this as well.

With that in mind, that would explain why the higher reading on Echo #1....as my pulse was probably 90 bpm during that..... whereas I saw on the screen I was hovering in the 54-56 bpm during Echo #2
 
Nothing wrong with the 50% on its own. I would think the difference is in the Lexapro you are taking. You were highly agitated the first time, and nearly asleep the second time. The 50% is likely much closer to what your heart really is, when you're not channeling a river of adrenaline. And yes, it could be exacerbated by a poor estimation on either (or both) of them, or even partly by a bad placement of you on your side for the echo.

The other thing to look at is for any abnormal heart wall movement or other indications in your echo (or rhythm issues in your electrocardiogram) of anything that would indicate a developing problem.

I don't see any value in attempting to manipulate yourself to get the score you believe you want for Ejection Fraction. If you were to achieve a 60, let's say, what value would it actually be, if that score only happens when you put yourself into a state that you don't normally live in. Your lower pulse is a positive indication of your running efforts.

And echoes aren't cheap (although it seems like they should be). Without a severe issue apparent, your insurance likely won't pay for another for at least six months.

Best wishes,
 
My main question is, if i am sitting here doing nothing...... or if I get up and sprint to the end of the block, does my EF stay the same?
I would guess NOT.

I think it will change with heart rate. I pulled my Sept 2010 echo and it says..."The LVEF is 70% at a HR of 65", so my guess is that HR does play a part. He further states..."There is normal left ventricle systolic function. The estimated Ejection Fraction is 70%". In Sept. 2009, the EF was 63% at a HR of 48 and his conclusion was the same, "normal".

While I find looking at these numbers fascinating, I leave it too him to properly interpret what all this stuff means. That's what I pay him for and "so far, so good".:smile2:
 
I can't speak to whether or not heart rate plays a role in EF, though it would seem to based on what Dick0236 is saying above. I do clearly recall that after my Cardiologist saw my very first echo 10 years ago he sent me straight to his favourite tech for a second one. I asked him why the redundant test and he said that there can be a huge difference between reports from different techs, and even machines. A year before my surgery I happened to get one for myself from another clinic and he did the same thing when he saw the report - sent me to his lab.
 
Seems like you would be feeling not so sweet if it were legit, or maybe just not as sweet.. but i'm not a doctor. I've never really seen my EF vary by more than 10 or 12%. I'd ask about it next time you see your doc.

Sometimes this stuff is more common sense than you might think. Say for example you get a cath done and you're super nervous. They're in there measuring the filling pressure, and it's higher than it should be. Well it could be that it's just your blood pressure was sky rocketed from going through such a stressful procedure. I'm kind of leaning in tobagotwo's direction on it... but again, we're not doctors, and you should ask yours about it. They will be able to tell best if it's something to worry about.
 
My doctor just told me (after I had an issue with a nurse practitioner putting too much emphasis on ejection fraction and ignoring symptoms) that ejection fractions can vary especially if the test is run by a different person or a different machine or read by a different doctor. He too said they are an estimate, just one piece of the puzzle. An analogy I have heard used is think about how much difference there are in scales when you are weighed, each machine varies as does the tech and doctor.
 
Thanks for your nice words guys.
It just seems like everytime I have a test done, it's another set back.
First I "may" have a bicuspid.... but told it's working fine...not to worry.
Then the aortic root was measured at 3.4, but told by two docs "forget about it, it will never get bigger"...last Echo said 3.8
Now, this E fraction thing.
Always something to worry about.

And because I am health obsessed which leads to anxiety is why I am on Lexapro.
On Lexapro, my BP stays nice and 110/65 all the time, and I don't get rattled by much...
But...it makes me soooo mellow almost to the point of lathargic sometimes.....
And if EF fluctuates up and down throughout the day like BP, pulse, and most other bodily functions....and I
find out this Lexapro is the cause of this drop in EF....the bottle of that will be chucked out in the street, and I'll
just have to deal with the anxiety naturally.
 
I was surprised to see oscillating results from a series of echo and non-echo cardiograms done on me in my cardiologist's office. This was on key numbers like the pressure drop across my (stenotic and regurg) BAV, and the (associated) cross-sectional area. Since we were keeping an eye on these numbers, while I was asymptomatic and competitively-athletically active, they were important as a guide to my BAV's "best before" date, and the timing of my AVR surgery. But instead of steadily deteriorating, one or two of the numbers showed a significant improvement!
The Cardiologist told me that improvement was essentially unheard-of, and at least one of the numbers must be wrong, based on a technician's mis-reading of the gizmo. (I didn't get the details.) The stress and non-stress tests were done by different teams, one of them in-house and the other outside contractors. Not amazingly, my cardio had less faith in the contractors.
After a "tie-breaker" test or two, I think it did turn out that it was the "good" result that was the outlier, and apparently wrong.

For me, the surprising take-home message was that some pretty important info is derived, deduced, or interpreted, rather than directly or reliably read from the EC screen.

I guess that's one reason why my surgeon is insisting on an Angiogram before he actually "goes in".

Surgery is Dec. 1, Angio is . . . tomorrow. They say they'll keep me in the hospital for ~5.5 hours, and the Angio will take maybe 25 minutes. Most of the rest is apparently keeping an eye on me afterwards to make sure I'm OK. Doesn't sound like fun; I think I'll search the site for "angio" now. . .
 
I once did a Google Search to see what the "standard definition" of Ejection Fraction was.
I found that there was NO concensus on the exact numbers from the Major Heart Hospitals, most spanning 15 percentage points.
They were ALL between 50% and 70%.

AND as others have pointed out, EF seems to be one of those parameters that ARE ESTIMATED and NOT measured directly.

'AL Capshaw'
 
At a 45% ef, I was doing great. Riding my bicycle 3000+ miles a year.

You need to be followed by someone who not only understands the results, but can interprete them based on YOU. There are many factors that a cardiologist will interpret to assist in making a decision as to whether you need surgery.

This year, when it was time, my cardio sat with me for an hour going over the results and explaining in length what was happening. He did this before telling me I needed surgery.

I am biased on this: you are close enough to Cleveland that I recommend getting to the CCF to be evaluated.
 

Latest posts

Back
Top