Dilated LV

Hallo,
My father's (63 years old) echo results are varying in their readings regarding LVESD, which is ranging beteen  between 6.1 and 6.8. (or 61-68) Why is it so?
He is a patient of heart failure but with very limited symptoms.
Even with increase in his LVESD he has not developed new symptoms.
He is under medications. What do these values mean?
What are the possible treatments available ?
Kindly advice
Thanks a lot
Ujjaini

[CCF HeartMD-2]

The measurement of the left ventricular end systolic dimension is a quantitative measurement of how dilated or enlarged the left ventricular cavity is.  The variability in the measurements may be related to several factors including interobserver variability in taking and reading the measurements, and potentially the natural progression of the disease, the latter would be less likely if he has very limited symptoms.  The former cause of variability is the fact that we are using a two dimensional measurement as a surrogate for a 3 dimensional measurement, or volume.  Practically speaking, another important measure we have is that of symptoms, as measured by the New York Heart Association Class (I-IV).  If your father has symptoms at rest then he is class IV.  If he is not limited at all, he is considered class I.  These functional classes are very important in terms of prognosis.  Treatments for congestive heart failure depend first on idenitfying if the cause is from a coronary artery blockage(also known as ischemic cardiomyopathy) or not.  Also, in the non coronary blockage category, there are some reversible causes of cardiomyopathy which should be investigated.  Once all these have been ruled out, then the diagnosis of dilated cardiomyopathy has been made, and medications shown to improve survival long term include beta blockers, ace inhibitors, aldosterone antagonists, among other things, and if there is a conduction delay, possible cardiac resynchronization therapy may help (special kind of pacemaker).  If the ejection fraction is less than or equal to 35%, then an ICD (defibrillator) may prolong survival as well.