Did your thickened heart walls, return to normal after valve replacement?

[drivetopless]

I was reading my last echo results and it seems I have some mild concentric hypertrophy (thickening without enlargement, causing reduced blood capacity) in the left ventricle.

I also have Grade II diastolic dysfunction. "Diastolic dysfunction is related with a preserved contraction of the heart, in which the heart ejects its volume sufficiently, but faces difficulty while relaxing adequately during the diastolic phase. As a result, the heart takes a longer time to fill up than usual, causing an increase in its filling pressure.. . . .Diastolic Dysfunction Grade 2 is moderate abnormality that symbolizes the intermediate phase. It includes slightly raised left ventricular end diastolic pressure, associated with dyspnea and minor functional damage."

I'm assuming these findings are common in late stage BAV with aortic stenosis.

I'm wondering if this is reversible and does your heart return to normal after AVR? I will ask the surgeon/cardiologist when I see him, but thought I might get some anecdotal stories about how your heart improved after surgery.
Thanks.

 

[ctyguy]

Interesting question....I go to see my cardio at the end of April for my 2 yr checkup. He didn't do an echo after yr 1 but I expect one this year and that is one of the questions I have also. My cardio called it an athletic heart. The heart being a muscle and my body was making it work harder due to the BAV and stenosis, hence it got thicker. He said back then that in time it would return to normal. So I will be sure to ask that question when I go in and see what the echo reveals....

 

[drivetopless]

Cool, Scott. Thanks for asking your cardiologist! I hope it is good news. I'm trying to find all of the positives to focus on for the future.

 

[Ross]

For me, the answer is NO. Mine was left go far too long and I've suffered the damage permanently. Usually, if caught early enough, it will return to a normal size.

 

[drivetopless]

Thanks, Ross. I always knew you had a big heart.

 

[Ross]

Thanks, Ross. I always knew you had a big heart.

Dangerously big. It weighs heavily on my mind everyday.

Cardiomyopathy or Cardiomegaly=Cardiougly.

 

[va66]

Dear Drivetopless:
I was interested in your recent post. I am two years post op from my aortic valve replacement for a bicuspid valve. My valve size had decreased over a period of several years to .7 which is classified as severe. I noted that this is your number at present.
My pre-surgical echo indicated that there was "mild concentric left ventricular hypertrophy." My first echo following AVR indicated mild LV diastolic dysfunction (a stiffening of the left ventricle which results in abnormal filling during diastole). My next echo which was done in February indicated "borderline left ventricular hypertrophy." I'll need to find out more about this during my May visit.
One of the questions I asked my cardiologist was whether or not the diastolic dysfunction could be either reversed or not progress to another level. He told me do do the following: (1) exercise one hour daily; (2) drink a lot of water and fluids; (3) limit salt and sugar; (4) keep my blood pressure stable. He also started me on a statin (Crestor) to bring down my high cholesterol and LDL. I have a follow-up appointment in May at which time I'll report on my blood results.
You did not indicate, however, whether or not you have scheduled your own surgery? Do let us know how you are doing!

 

[MarkU]

I had developed some left ventricular hypertrophy prior to my AVR. When they had me opened up they discovered that the calcification of my valve was much worse than they had suspected - my surgeon said it some of the worst he had seen. That made them somewhat pessimistic about the enlargement - my surgeon told me that he thought it was going to be permanent.
Fortunately it reversed itself within the next eighteen months to where the enlargment was within the margin of error of the the echocardiogram.
I feel pretty fortunate.
Mark

 

[drivetopless]

Ross. :-(

VA66- Wow, I am in the same place you were at surgery. I have my first surgical consult this coming Tuesday. I will talk to two other surgeons, more than anything for selecting who I'm comfortable to perform the procedure.

Mark- That is AWESOME to hear. Gives me hope. Hopefully, I am young enough (46) for the heart to recover over time. It can't get much worse at least if I have it fixed soon. It will be interesting to see what the calcification level is on my valve. You can see it in the echo--looks like barnacles to me.

 

[JeffM]

Ross. :-(

VA66- Wow, I am in the same place you were at surgery. I have my first surgical consult this coming Tuesday. I will talk to two other surgeons, more than anything for selecting who I'm comfortable to perform the procedure.

Mark- That is AWESOME to hear. Gives me hope. Hopefully, I am young enough (46) for the heart to recover over time. It can't get much worse at least if I have it fixed soon. It will be interesting to see what the calcification level is on my valve. You can see it in the echo--looks like barnacles to me.

My experience should give you some hope too. My 1 month echo showed very noticeable reduced left ventricle size and wall thickness and my 1 year echo showed continued remodelling of my heart that included continued reduction of my left ventricle size and wall thickness. The only thing that hasn't chaged is my slight left atrial enlargement. But it doesn't seem to be creating any problems for me. I like the advice from VA66's Cardio. If you can exercise; you should exercise. And a low fat, low sugar, low salt diet that includes adequate hydration, we all know, is the way to go.

 

[drivetopless]

Had my first surgical consultation today, so I ask Dr. J. Wolfe in Atlanta about a heart that is thickened returning to "normal" range after surgery. In particular, I asked him about my heart situation. He said that it should return to normal over time after AVR. Yay.

 

[Jeanie]

While I was researching this topic a few weeks ago, I found a research abstract that says if the ventricle enlargement can reduce, it will over a period of no quicker than 6 months' time. One of the articles mentioned they were studying specifically the effect of dietary supplementation with Co Q10, and that it had a positve correlation with improvement in ventricle size and function. I will try to find the article again, but not right this minute, sorry.

What both my surgeon and cardiologist said on the subject is, they try to keep BP and HR lowered for at least a few months post-op to reduce the heart's workload. They explained it by saying even though the newly repaired heart can work harder, it is best not to allow it to do so for awhile. That is why the cardiac rehab exercise regimen is usually set up for very gradual increase in exercise level, too.

I am at the almost 3 months after surgery point, and have had 2 echos post-op and a TEE. Each one is showing improvement thus far in ejection fraction, and ventricle function. So, I hope that also gives you hope that yes, there can and likely will be some improvement, unless (very sad to read of your situation Ross) the damage to the heart was too severe, for too prolonged of a time.