How to best preserve the valve

[csigabiga]

Hi All,

I'm relatively new here. I'm 37 years old with moderate + regurgitation. I'm currently on 100mg of Losartan a day, and starting to get nervous that my surgery is getting closer.

I'm wondering if anyone knows of ways I can preserve my aortic valve as long as possible.

I'm particularly wondering about eating habits and exercise habits, but open to hearing any other tips and ideas.

With regards to eating, I'd say I eat a pretty healthy diet, but should I try to eat even less of certain fats? less sodium? Does it probably not matter as long as I'm not eating junk every meal (which I don't)?

And with regards to exercise, should I keep an eye on my heart rate? My doctor advised me against isometric exercise but said aerobic should be OK. I still go on short jogs of 3-6 km, but this gets my heart rate quite high (not abnormally high, I'd guess 170-180). Do these potentially weaken the valve even more?

I know there's a lot of knowledge on this message board so any thoughts on nutrition, exercise, or anything else would be greatly appreciated.

 

[nobog]

csigabiga;

What wears a heart valve out? The same thing that wears everything out - load (your blood pressure - "normal" is 120/80 mmHg) and cycle count (at 70 beats per minute that's about 40 million per year). There are other factors that you cannot control, body chemistry, your family medical health etc but those are the 2 biggies.

So.. like most things in life, moderation is the key,

Welcome to the forum!

 

[Chuck C]

Hi All,

I'm relatively new here. I'm 37 years old with moderate + regurgitation. I'm currently on 100mg of Losartan a day, and starting to get nervous that my surgery is getting closer.

I'm wondering if anyone knows of ways I can preserve my aortic valve as long as possible.

I'm particularly wondering about eating habits and exercise habits, but open to hearing any other tips and ideas.

With regards to eating, I'd say I eat a pretty healthy diet, but should I try to eat even less of certain fats? less sodium? Does it probably not matter as long as I'm not eating junk every meal (which I don't)?

And with regards to exercise, should I keep an eye on my heart rate? My doctor advised me against isometric exercise but said aerobic should be OK. I still go on short jogs of 3-6 km, but this gets my heart rate quite high (not abnormally high, I'd guess 170-180). Do these potentially weaken the valve even more?

I know there's a lot of knowledge on this message board so any thoughts on nutrition, exercise, or anything else would be greatly appreciated.

Welcome to the forum!
Can you provide a little more information?
" I'm 37 years old with moderate + regurgitation. "
By this do you mean to say that you have moderate aortic stenosis and regurgitation?
Do you have a bicuspid valve? Does your medical team know why your valve is regurgitant? Do you have calcification on your valve or any degree of aortic stenosis?

I'll assume for the moment that by moderate you mean moderate aortic stenosis. There is no evidence of any treatment to slow aortic stenosis, although keeping good health, such as normal blood pressure, optimal BMI, healthy diet and regular exercise are good ideas regardless of whether they will slow progression of aortic stenosis.

"I still go on short jogs of 3-6 km, but this gets my heart rate quite high (not abnormally high, I'd guess 170-180). Do these potentially weaken the valve even more?"

I believe that one can come up with a hypothesis that exercise could accelerate stenosis, but I doubt that it will. Even if exercise temporarily elevates your pulse and blood pressure, it has the effect of lowering your resting pulse- likely resulting in fewer total beats per day and lowering your resting blood pressure in general. Plus, regular exercise and staying fit will be a huge benefit if you can maintain that fitness heading into surgery, when that time comes. Let's hope that it is many years away. Some people take many years to progress from moderate to severe stenosis.

Beware the hope peddlers. You are nervous and looking for something to slow down your valve disease. You might come across internet sources that make unproven claims, such as that vitamin K2 will slow down or reverse aortic stenosis. Prior to my surgery I read this online and researched the issue. There is no evidence of this, just someone came up with the hypothesis, but it is yet to be tested. Still, as it appeared it would do me no harm and is correlated with some improved heart health metrics, I did take K2 for 18 months while in the moderate stenosis range. I took it without any false hope, but sort of just in case. It did me no good and my stenosis continued to progress to severe.

Regardless of whether you are successful in achieving your goal of slowing it down, you have come to the right place to read and learn from others who have been in your shoes. I remember well being in the moderate stenosis range and really wishing I could find a way to slow it down. It can be a bit scary facing the unknown, and hopefully the experience of others here can help you with that.

 

[cldlhd]

I've been curious about this occasionally myself. There are two separate things obviously- You have calcification and regurgitation. I imagine calcification can largely be influenced by diet, exercise and a generally healthy lifestyle But regarding regurgitation I'm not really sure there's much can be done. I had my surgery at 45 in my valve showed no signs of regurgitation but after my surgery it still showed trace regurgitation ( with higher velocity which doesn't sound real good to me). I always assumed that really heavy weight lifting and such and working out super intensely might not be good for regurgitation but that's just my gut instinct. I feel the same way regarding aneurysm. When I was younger, like late teens up until around 30 I did lift weights pretty intensely from time to time but I often wondered if that contributed to making my aneurysm worse. My surgeon said that he doubts it but who knows? Either way it's out of there now so the way I see it I try to eat a little healthier (The wife buys me ice cream but I only eat a little on the weekend for the most part) I enjoy one or two beers probably three or four days a week but I don't think that's particularly bad. Thanks to my wife I eat a lot healthier, she buys a lot of healthy food. Like last night I had a Nice big healthy salad before salmon for dinner. I have found that I feel better when I eat healthy although I'm not sure how much of that is mental. I try to do moderate exercise like walking pretty much every day, a casual walk with the dog and if it's not too hot a more brisk one with my wife. I also ride my bike somewhat regularly. Other than that and keeping an eye on your cholesterol I'm not really sure what could be done.

 

[nobog]

Just a note about regurgitation:

This can really be broken down between tissue and mechanical valves.

Regurgitation = backflow (leaflets closing) + leakage (leaflets closed)

All valves - even your native valve have backflow but it is minimal. A properly operating tissue valve will have backflow and but no leakage.

Mechanical valves will have backflow and leakage - there are clearances and they are designed to "leak". Larger sized mechanical valves have higher regurgitation than smaller mechanical valves - its just a physics thing - more area = more backflow and leakage.

Measuring regurgitation can be tricky because the cardiac output (lets say the difference between 3 liters per minute and 8 liters per minute) will change the % of regurgitation although the actual amount (volume) stays about constant.

* higher blood pressure increase regurgitation for mechanical valves (and wear out tissue valves faster)
* pin-holes and center jets are not uncommon for tissue valves
* any valve can have a leak around the cuff during implant which is usually measured as a high velocity jet, these usually heal by themselves - that's one of the main issues with TAVI valves (lots of leakage) - there is no cuff as in a standard surgical valve (this is why I say to find a valve with a nice fluffy cuff - that's your gasket).
* and.. for you ball and cage valves owners - you will have have backflow but no leakage - the silicone ball seals positively.

 

[cldlhd]

Just a note about regurgitation:

This can really be broken down between tissue and mechanical valves.

Regurgitation = backflow (leaflets closing) + leakage (leaflets closed)

All valves - even your native valve have backflow but it is minimal. A properly operating tissue valve will have backflow and but no leakage.

Mechanical valves will have backflow and leakage - there are clearances and they are designed to "leak". Larger sized mechanical valves have higher regurgitation than smaller mechanical valves - its just a physics thing - more area = more backflow and leakage.

Measuring regurgitation can be tricky because the cardiac output (lets say the difference between 3 liters per minute and 8 liters per minute) will change the % of regurgitation although the actual amount (volume) stays about constant.

* higher blood pressure increase regurgitation for mechanical valves (and wear out tissue valves faster)
* pin-holes and center jets are not uncommon for tissue valves
* any valve can have a leak around the cuff during implant which is usually measured as a high velocity jet, these usually heal by themselves - that's one of the main issues with TAVI valves (lots of leakage) - there is no cuff as in a standard surgical valve (this is why I say to find a valve with a nice fluffy cuff - that's your gasket).
* and.. for you ball and cage valves owners - you will have have backflow but no leakage - the silicone ball seals positively.

Not disagreeing with anything you said but I think the original post was more about preserving the original aortic valve as long as possible as to postpone or possibly avoid replacement altogether

 

[cldlhd]

Welcome to the forum!
Can you provide a little more information?
" I'm 37 years old with moderate + regurgitation. "
By this do you mean to say that you have moderate aortic stenosis and regurgitation?
Do you have a bicuspid valve? Does your medical team know why your valve is regurgitant? Do you have calcification on your valve or any degree of aortic stenosis?

I'll assume for the moment that by moderate you mean moderate aortic stenosis. There is no evidence of any treatment to slow aortic stenosis, although keeping good health, such as normal blood pressure, optimal BMI, healthy diet and regular exercise are good ideas regardless of whether they will slow progression of aortic stenosis.

"I still go on short jogs of 3-6 km, but this gets my heart rate quite high (not abnormally high, I'd guess 170-180). Do these potentially weaken the valve even more?"

I believe that one can come up with a hypothesis that exercise could accelerate stenosis, but I doubt that it will. Even if exercise temporarily elevates your pulse and blood pressure, it has the effect of lowering your resting pulse- likely resulting in fewer total beats per day and lowering your resting blood pressure in general. Plus, regular exercise and staying fit will be a huge benefit if you can maintain that fitness heading into surgery, when that time comes. Let's hope that it is many years away. Some people take many years to progress from moderate to severe stenosis.

Beware the hope peddlers. You are nervous and looking for something to slow down your valve disease. You might come across internet sources that make unproven claims, such as that vitamin K2 will slow down or reverse aortic stenosis. Prior to my surgery I read this online and researched the issue. There is no evidence of this, just someone came up with the hypothesis, but it is yet to be tested. Still, as it appeared it would do me no harm and is correlated with some improved heart health metrics, I did take K2 for 18 months while in the moderate stenosis range. I took it without any false hope, but sort of just in case. It did me no good and my stenosis continued to progress to severe.

Regardless of whether you are successful in achieving your goal of slowing it down, you have come to the right place to read and learn from others who have been in your shoes. I remember well being in the moderate stenosis range and really wishing I could find a way to slow it down. It can be a bit scary facing the unknown, and hopefully the experience of others here can help you with that.

Yeah I've been taking vitamin K2 mk7 somewhat regular for the last few years. I'm not sure if it works but the evidence, even if anecdotal for the most part, does seem to show that it at least doesn't hurt. I'm doing it more hoping it slows or stops calcification as my valve had no calcification at the age of 45 when I had surgery, I'm 52 now, but there was some calcification that showed up in my one coronary artery on my CT angio They ran a cardiac cath and it turns out the artery was clear but there was one spot with calcium inside the arterial wall (aka hardening of the arteries). Other than that it seemed pretty clear and having read about vitamin K2 again I figured what the hell it can't hurt.

 

[almost_hectic]

Live your life. None of us can definitively say what would help you prolong the time until surgery will be necessary. Stay healthy and eat healthy, avoid the obvious bad things, but live your life. After surgery you’ll have to make some adjustments. I say do it then and not now. I was in the waiting room for over ten years before it was time for surgery. My cardiologist had me on preventative meds thinking he was helping me prolong my leaky valve, I hated them they made me feel like crap. In the end I still needed surgery. I wish I could have had surgery sooner actually, instead of prolonging the inevitable and not enjoying the health I did have. There was no reason to avoid it, there was nothing to fear. I would have much rather lived a normal life leading up to surgery instead of one on meds and avoiding things that were potentially bad for me. Live your life now. My two cents.

 

[charlottekaye]

Live your life. None of us can definitively say what would help you prolong the time until surgery will be necessary. Stay healthy and eat healthy, avoid the obvious bad things, but live your life. After surgery you’ll have to make some adjustments. I say do it then and not now. I was in the waiting room for over ten years before it was time for surgery. My cardiologist had me on preventative meds thinking he was helping me prolong my leaky valve, I hated them they made me feel like crap. In the end I still needed surgery. I wish I could have had surgery sooner actually, instead of prolonging the inevitable and not enjoying the health I did have. There was no reason to avoid it, there was nothing to fear. I would have much rather lived a normal life leading up to surgery instead of one on meds and avoiding things that were potentially bad for me. Live your life now. My two cents.

Brav- effin-O!

 

[csigabiga]

Hi.

Thanks to everyone for the replies. Yes, the original post was about preserving my original aortic valve, which currently has moderate plus regurgitation and no stenosis that I'm aware of. I think I eat healthy enough, walk the dog, occasionally jog, and generally abide by the live your life philosophy. I used to play squash but my cardio advised me to stop and to start taking blood pressure meds. I comply with both recommendations. After reading these posts I will continue doing what I'm doing without worrying about the impact on the valve. As I have a check up in 2 weeks, and am "in the waiting room", I'm sure I'll have more questions in the future. Happy to be a part of such a knowledgable supportive community.

 

[almost_hectic]

start taking blood pressure meds. I comply with both recommendations.

Do you actually have high blood pressure and is that why he's got you on those meds? Im not your doctor so I won't pretend to advise you, but Im curious why theyve got you on BP meds. Thats what my cardio did, my blood pressure wasn't anywhere near high BP. But my cardio felt it would be helpful to take some strain off the valve if I was on meds. Thats what I was describing when I said they made me feel like crap. Even when I complained he insisted I HAD to be on them and to get used to it. Man, they used to mess up my stomach and make me feel sick and dizzy, low energy, just awful. And that was the one drug with the least side effects, he previously tried me on others I refused to stay on. After all those years I don't think they were worth it and I just wasn't living the otherwise good health that I did have. I would never advise you to not take medication the doctor feels you should be on, I just wonder if its for the same reason as mine was or do you have high BP?

 

[cldlhd]

Do you actually have high blood pressure and is that why he's got you on those meds? Im not your doctor so I won't pretend to advise you, but Im curious why theyve got you on BP meds. Thats what my cardio did, my blood pressure wasn't anywhere near high BP. But my cardio felt it would be helpful to take some strain off the valve if I was on meds. Thats what I was describing when I said they made me feel like crap. Even when I complained he insisted I HAD to be on them and to get used to it. Man, they used to mess up my stomach and make me feel sick and dizzy, low energy, just awful. And that was the one drug with the least side effects, he previously tried me on others I refused to stay on. After all those years I don't think they were worth it and I just wasn't living the otherwise good health that I did have. I would never advise you to not take medication the doctor feels you should be on, I just wonder if its for the same reason as mine was or do you have high BP?

I'd have to imagine to try to prevent higher blood pressure from damaging the valve. He didn't mention an aneurysm. When I was diagnosed with an aneurysm even though my blood pressure was 115/75 when I was tested at rest they put me on blood pressure meds under the theory that if it's spiked due to stress, road rage or general anger ( not a very angry person btw) I could have had a major issue. I didn't like the way they made me feel either especially considering sometimes I would wake up during the night and feel really out of it and I would check my blood pressure and pulse and they would both be pretty low. Luckily I wasn't on them long because I had surgery 11 months after my diagnosis.

 

[tom in MO]

almost_hectic is correct. Just live your life. There is nothing specific that will help you eat or exercise your way out of a valve replacement if it is in your future.

Blood pressure control is just good overall cardio vascular health, but if you have normal BP, there should be no need for meds.

To me having you drop squash for mild regurgitation seems odd when the cardio allows you to jog 6 km and do aerobic exercises. Squash is good aerobic exercise. I'd ask for more clarification or get a second opinion.

I see from your location that you may be using public health services. Make sure you keep a sharp eye on the competency of your specialists and the need for routine expensive tests since you have limited choices and often overburdened facilities focused on economically conservative care.

 

[csigabiga]

Do you actually have high blood pressure and is that why he's got you on those meds? Im not your doctor so I won't pretend to advise you, but Im curious why theyve got you on BP meds. Thats what my cardio did, my blood pressure wasn't anywhere near high BP. But my cardio felt it would be helpful to take some strain off the valve if I was on meds. Thats what I was describing when I said they made me feel like crap. Even when I complained he insisted I HAD to be on them and to get used to it. Man, they used to mess up my stomach and make me feel sick and dizzy, low energy, just awful. And that was the one drug with the least side effects, he previously tried me on others I refused to stay on. After all those years I don't think they were worth it and I just wasn't living the otherwise good health that I did have. I would never advise you to not take medication the doctor feels you should be on, I just wonder if its for the same reason as mine was or do you have high BP?

My cardiologist put me on the BP meds for the exact reasons yours did. I saught a second opinion who was neutral on taking BP meds. Thankfully they don't bother me too much, so I decided there's no harm in trying

To me having you drop squash for mild regurgitation seems odd when the cardio allows you to jog 6 km and do aerobic exercises. Squash is good aerobic exercise. I'd ask for more clarification or get a second opinion.

I see from your location that you may be using public health services. Make sure you keep a sharp eye on the competency of your specialists and the need for routine expensive tests since you have limited choices and often overburdened facilities focused on economically conservative care.

It's moderate plus regurgitation (borderline severe from what I understand). They way he explained it was that the short sprints in squash were more problematic than a gradual rise and fall cardio wise. I have no idea how that makes sense, but again, I figure it's probably better to listen than not. I feel pretty good about the care I have gotten. A check up every 9 months or so which is either an Eco, an EKG or a stress test. Next one is in 2 weeks

 

[Jerry D]

I did not have high BP or bad cholesterol before my aortic valve replacement (bovine), but my cardiologist put me on low dose atenolol and atorvastin (Lipitor) after the surgery. I had a couple of afib episodes in the three months after the surgery (one brought me to the ER) and he put me diltiazem. I never had any ill effect from the meds. I coach and race 6-man outriggers and 12 miles in the ocean does not tax me. My doc says the meds are prophylactic keeping things in shape for my valve.

 

[Chuck C]

I coach and race 6-man outriggers and 12 miles in the ocean does not tax me.

That's great to hear Jerry! How long ago was your surgery?