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Heart Disease (Expert Forum)
Re: Ejection fraction
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Re: Ejection fraction
by CCF CARDIO MD DLB, Jan 01, 1995 12:00AM
Posted By CCF CARDIO MD - DLB on August 29, 1998 at 13:00:33:
In Reply to: Ejection fraction posted by Scott on August 29, 1998 at 12:30:23:
I am a 500 lb man who recently posted a question on the board regarding a heart problem which had been diagnosed about a month ago. I have decreased my caloric intake to around 1200 calories per day and increased my physical activity dramatically. Since August 4th, I have lost 45 lbs. I was diagnosed because I had an episode of atrial fib.
As I want to take care of myself as well as I can, under the circumstances, I have some other questions which I had not previosly answered.
1. My ejection fraction is in the mid to low 40's. Is it reasonable to expect this to improve with weight loss? And if so how much might it improve?
2. All four chambers of my heart are dilated. Is it possible that my heart size decrease as I lose weight or will it continue to increase?
3. Can a heart that has been damaged by excessive weight function normally, or will it continue to deteriorate even after the weight loss?
4. How frequently should I have a TEE or equivalent so as to adjust my treatment accordingly?
5. Besides correcting my diet, taking medication as prescribed and exercise is there anything I can do to become "heart healthy" again?
6. Is it possible that the atrial fib will go away as I continue to lose weight and exercise?
7. Are you aware of any heart clinics that have the equipment and specialization to treat people with morbid obesity and its effects on the heart?
Thank you
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Dear Scott
There is a good chance that your ejection fraction [EF] will normalize if you lose a substantial amount of weight. To clarify, a normal EF is about 60%, not a 100%, so an EF of 40% is not normal, but is not horrible either.
Similarly, the dilation should revert to normal with substantial weight loss. There should be no further deterioration in heart function after the weight loss.
I do not recommend routine TEEs. Assuming that there were no other abnormalities on your echo, it would be most useful to follow your symptoms and adjust medications on that basis. Regardless of what the TEE shows at this point or in the future, any sensible doctor would urge you to continue losing much more weight. After you have lost a substantial amount of weight (hundreds of pounds), it may be reasonable to do another echo just to make sure that there is no other pathology in your heart that was missed (valve abnormalities for example) causing the dilation.
Diet and exercise are the only ways for your heart to become healthy. My only advice would be to avoid any quick weight loss scams or bogus health food supplements. Discipline and hard work for a long time will be the only way for you to lose weight safely and keep it off.
There is a good chance (though not a certainty) that as you lose weight, your heart size will normalize. As your heart size normalizes, the stimulus for the atria to fibrillate will decrease, and the atrial fibrillation may stop. I suspect this is a long way off and would urge you to continue taking the medicines your cardiologist prescribes.
Regarding special heart clinics for the morbidly obese, I know of none. However, your focus should be on safe weight loss and any weight loss clinic affiliated with a reputable hospital should be able to help you. In addition to damaging your heart, morbid obesity can damage your health in other ways.
I hope this is useful. Feel free to write back. I wish you the best of luck and congratulations on starting the weight loss process.
If you would like to set up an appointment with one of our cardiologists here at the Cleveland Clinic please feel free to call 1-800-CCF-CARE.
Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of any particular medical condition can only be made by your physician(s).
In Reply to: Ejection fraction posted by Scott on August 29, 1998 at 12:30:23:
I am a 500 lb man who recently posted a question on the board regarding a heart problem which had been diagnosed about a month ago. I have decreased my caloric intake to around 1200 calories per day and increased my physical activity dramatically. Since August 4th, I have lost 45 lbs. I was diagnosed because I had an episode of atrial fib.
As I want to take care of myself as well as I can, under the circumstances, I have some other questions which I had not previosly answered.
1. My ejection fraction is in the mid to low 40's. Is it reasonable to expect this to improve with weight loss? And if so how much might it improve?
2. All four chambers of my heart are dilated. Is it possible that my heart size decrease as I lose weight or will it continue to increase?
3. Can a heart that has been damaged by excessive weight function normally, or will it continue to deteriorate even after the weight loss?
4. How frequently should I have a TEE or equivalent so as to adjust my treatment accordingly?
5. Besides correcting my diet, taking medication as prescribed and exercise is there anything I can do to become "heart healthy" again?
6. Is it possible that the atrial fib will go away as I continue to lose weight and exercise?
7. Are you aware of any heart clinics that have the equipment and specialization to treat people with morbid obesity and its effects on the heart?
Thank you
-------------------------------------------------------------------------------------------------------------
Dear Scott
There is a good chance that your ejection fraction [EF] will normalize if you lose a substantial amount of weight. To clarify, a normal EF is about 60%, not a 100%, so an EF of 40% is not normal, but is not horrible either.
Similarly, the dilation should revert to normal with substantial weight loss. There should be no further deterioration in heart function after the weight loss.
I do not recommend routine TEEs. Assuming that there were no other abnormalities on your echo, it would be most useful to follow your symptoms and adjust medications on that basis. Regardless of what the TEE shows at this point or in the future, any sensible doctor would urge you to continue losing much more weight. After you have lost a substantial amount of weight (hundreds of pounds), it may be reasonable to do another echo just to make sure that there is no other pathology in your heart that was missed (valve abnormalities for example) causing the dilation.
Diet and exercise are the only ways for your heart to become healthy. My only advice would be to avoid any quick weight loss scams or bogus health food supplements. Discipline and hard work for a long time will be the only way for you to lose weight safely and keep it off.
There is a good chance (though not a certainty) that as you lose weight, your heart size will normalize. As your heart size normalizes, the stimulus for the atria to fibrillate will decrease, and the atrial fibrillation may stop. I suspect this is a long way off and would urge you to continue taking the medicines your cardiologist prescribes.
Regarding special heart clinics for the morbidly obese, I know of none. However, your focus should be on safe weight loss and any weight loss clinic affiliated with a reputable hospital should be able to help you. In addition to damaging your heart, morbid obesity can damage your health in other ways.
I hope this is useful. Feel free to write back. I wish you the best of luck and congratulations on starting the weight loss process.
If you would like to set up an appointment with one of our cardiologists here at the Cleveland Clinic please feel free to call 1-800-CCF-CARE.
Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of any particular medical condition can only be made by your physician(s).
