LVEF 20%

[nspower]

My LVEF has been at 30% for last 5 years. It was caused by a heart attack. Last weeks ECHO results show the EF as 20%. I got it redone at another diagnostic centre and the result is same. The report shows max. LVed 7.0 cm from 6.5 cm in previous year. The minimum is 5.9 cm as in previous year. This happened in last one year and I did not feel any problem during my daily routine. In fact I was feeling better than before.
My questions are:
1. Can a 10% deterioration in EF have no impact on physical capability? From what I have heard, at 20% things have to be pretty bad.
2. Is this reversible?

Many thanks

Regards

[nspower]

Many thanks ed34

[ed34]

EF drop can sneak up on people and you won't be aware of it especially if on medication. Not until, that is, it provides symptoms. Stem cell research has a long way to go yet. A trial has only just started in Europe involving over 3000 patients and this I believe is a 5 year trial. Then the results will be collected and it will probably take another 10 years to decide who (if anyone) could benefit and cut through all the red tape. Some clinics in the World claim to actually give this treatment now, promising all kinds of brilliant results, but when asked for scientific evidence they seem to stay very quiet. This makes me suspicious that they just prey on the hopes of patients. I think the thallium scan would be an excellent move and will show if the necrotic tissue has spread through ischemia, or if there is a reversible blockage going on.

[nspower]

Thanks ed34.
My echo test was a stress test where they take echo measurements before and after stress test. The test was negative and EF before and after was 20% and 25% respectively. Despite low ef, I have not observed any symptom which could indicate ischemia. But yes, I plan to go for stress thallium test in few months and that may provide additional information on ischemia. As for BP, I regularly take ace inhibitors and maintain BP at 110/70. I also practice yoga on regular basis which helps keep BP in control. So, this may be ruled out.
From my fitness point of view, I have only seen improvement over the time and never thought something is going wrong. I surprised this deterioration has happened in just one year.
I have a large section of muscle damage and necrotic muscles may be something to look into. I will take up with my cardiologist in next visit. But this must be a major surgery?
Anything worth exploring in stemcell area? I heard, some trials are in advance stage. Please let me know if you have some inputs in this regard.
Regards

[ed34]

From what I gather, there are a number of things which can influence such things and it's important to have the right tests to establish what's going on so the appropriate course of action can be taken. One reason for your lowering EF which needs to be ruled out is further ischemia. If blood flow is more restricted through the coronary arteries, your EF will lower. This is obviously a reversible situation. Another thing that was explained to me a few years ago is that if enough heart muscle has become necrotic, the heart can reshape itself over years, causing a lower output. I am not sure, but perhaps surgery is available to remove some of the necrotic muscle. This is something you could discuss with your cardiologist. Other things could be things like high blood pressure, forcing the heart to try and compensate, enlarging and weakening. Are you due more tests soon?