Riddle me this docs...(Heart question) PLEASE, please help! :)

[scottwvu]

Will improving LV diastolic dysfunction help lower pulmonary pressures due to secondary pulmonary hypertension?
The facts (echo):
1. LV "mildly" hypertrophic (posterior wall thickness- 1.5 cm, septal thickness 1.2cm).
2."suggestion of concentric left ventricular hypertrophy".
3.LV ejection fraction normal.
4.Mital valve and aortic valve areas are reduced (although I have researched this, and according to the #'s on the echo, the aortic area is normal at 2.5cm)
5.Reduced LVcompliance= LV diastolic dysfunction AND
6. RV systolic pressure of 46.81 suggestive of mild to moderate pulmonary hypertension.

I guess I am just needing some hope, as I have been doing something I probably should not do:(searching  the internet reading outdated info that scares the heck out of me).
ANY info would be greatly appreciated!!!!!

[erijon]

Please be aware there are no doctors on this board, you can try either the Heart Disease or Interventional Cardiology Expert Forums as well.

More information would be helpful, how old are you, any previous heart disease, other risk factors?

The walls of your left ventricle have thickened, this can cause the chamber to not pump efficiently. The good news is that your EF is normal.

Sometimes, however, due to various medical conditions, the ventricles become relatively "stiff." Stiff ventricles cannot fully relax during diastole, and as a result the ventricles may not fill completely, and blood can "dam up" in the body's organs (mainly the lungs). An abnormal "stiffening" of the ventricles, and the resulting abnormal ventricular filling during diastole, is referred to as diastolic dysfunction. This can be due to your thickened LV walls.

Pulmonary hypertension begins when tiny arteries in your lungs, called pulmonary arteries and capillaries, become narrowed, blocked or destroyed. This makes it harder for blood to flow through your lungs, which raises pressure within the pulmonary arteries. As the pressure builds, your heart's lower right chamber (right ventricle) must work harder to pump blood through your lungs, eventually causing your heart muscle to weaken and sometimes fail completely. Again, this could be causing the walls of your LV to thicken. It is important to find the underlying cause of your condition.

Have your doctors ordered more tests?

Hope some of this helps,

Jon

[kenkeith]

I appreciate your personal note, but I don't have much to add to what Jon has stated.  It is important to dx the underlying cause.  Usually, it is sustained hypertension that causes concentric hypertrophy, and EF preservation in that the hypertrophic process is adaptive (initially) to the increased afterload that is imposed by an elevated bp.  However, the hypertrophic process develops cellular level (cardiac myocytes) maladaption changes effecting contractility.  

You haven't given your age but hypertrophy has been linked to aging and shown to parallel age-related arterial stiffening and elevation of systolic blood pressure. These factors may be associated with lacunar strokes. Concentric remodeling is associated with carotid intima-media thickening in hypertensive patients. Patients with concentric hypertrophy also show an increase in arterial wall thickness, even in general population studies. Concentric remodeling has even mysteriously been linked to insulin resistance in elderly men, suggesting as yet unknown disease mechanisms connecting the myocardium to metabolic disturbances.

Compunding the problem iIt is not yet entirely clear whether LVH represents "a marker, a limited adaptative process or a pathological process, amenable to different therapeutic strategies. The good news it seems clear that it responds to treatment. It has been found that physical activity decreases stroke risk in patients with increased left ventricular mass. Antihypertensive treatment reduces LV mass.  

For insight hypertrophy in medical terms means enlargement of the size and concentric means all round. In terms of heart, concentric LV hypertrophy means that the muscle of the left sided pumping chamber of the heart has increased in size and thickness. This usually occurs because of either high blood pressure or any obstruction to the outflow of blood from the left heart. Commonest example of latter is narrowing of the valve (aortic valve...gtradient pressure, LVOT left ventricle output tract are condiserations). Your doctor should be able to tell you as to the real reason of this LV hypertrophy (may need further testiung). Remedial measures can only be taken once you know the cause of LV hypertrophy.