EF and Heart size remain the same

Posted By Scott on July 17, 1999 at 11:03:49
I am a 33 year old male. As the result of a TEE performed in August of '98 I was diagnosed with dilated cardiomyopathy (four chambers) and atrial fib. My EF was 40%. This previous week I underwent another TEE to determine if there was any change in heart functioning from last year. During the past year I have lost 100lbs, stopped smoking, drink alcohol infrequently, and began to participate in aerobic exercise 3-4 per week. While I continue to have brief bouts of AF (usually lasting 1-2 hours...but occassionally 7-8 hours after which I have converted back to sinus), I feel much better physically, my energy level has increased, and my endurance for physical activity has improved dramatically. While I am still morbidly obese (400lbs - I am continuing to lose weight), I was hopeful that my newly acquired stamina was due in part to an increased EF and a decreased heart size. The results of the TEE were exactly as they were last year, no improvement nor deterioration. This was disappointing to me. I had hoped that my heart function had improved since last year. The cardiologist who performed the TEE explained that my cardiomyopathy may have been as a result of a virus and not because of my size or hypertension. He stated that this diagnostic impression agreed with the fact that there was no change in my cardiac functioning/heart size. He stated that since I am primarily asymptomatic and if I continued to tolerate medications well (Rythmol, Toprol XL, Mavik, Diazide, Coumadin, Aspirin, and Liptor (liptor)) that the results were encouraging.
Please help me understand why this is encouraging.
1. Based upon your knowledge and statistics, is it likely or unlikely that I will see an increased EF and/or decreased heart size if I continue on my current treatment plan (weight-loss, medication regime, controlled hypertension, exercise)?
2. Has your clinic had much experience treating morbidly obese patients with similar pathologies?
3. If so how well did they fair?
4. While I am not asking for an evaluation, merely information; does my current treatment plan seem appropriate?
5. What is the usual progression of dilated cardiomyopathy in patients such as myself?
6. If you have information on mortality rates for other patients similarly situated, please advise, if not, do you know of any resources that might have this information?
Thank you for your time. You provide a valuable resource.










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