cardiomyopathy and coreg

i have a 21 yr old daughter who is mentally impaired. she was diagnosed in march 05 with idiopathic dilated cardiomyopathy with an ejection fraction of 35-38%. she was started on 6.25mgs of coreg 2x day and vasotec 2.5mg 2xday. since then the coreg has been increased to 25mgs 2x day and kept vasotec the same. her latest echo showed an increase in mitral valve regurg from mild(she has always had mild leakage due an abnormality near the valve) to now moderate regurg and now mild tricuspid regurg where there was none before.  there has been no significant increase in heart function, her ef at last echo was 45%, but showed 35% at cardiac MRI  she had a TEE today to further study the abnormality near mitral valve, and her monitor showed very irregular heartbeats, and twice in 30 mins her pulse rate dropped to 30, but quickly recovered. her dr. says there is no change and to come for her scheduled visit next month. i am very torn at this point. part of me thinks we should get another opinion, as i am very concerned that there has been no significant improvement, and i worry about the mitral valve regurg increase causing more load on her already weakened left ventrricle. if anyone has had a similar situation, or has regained some function with the use of coreg, please let me know    thanks, dawn

[anacyde]

Hi.  Coreg is one of the best (if not the best) drug of it's kind for cardiomyopathy.  It can take some time to see improvement if improvement comes.  Mild regurgitation isn't uncommon with cardiomyopathy if there is heart enlargement, so if she had it before it could have worsened with the CM. As far as having any major impact on her LV size, from what I have heard from others with CM, I think it would have to be pretty significant.

Sending good thoughts your way!

[ddavey]

thanks for your answer. she had TEE last week and the ejection fraction is 35% with moderate dysfunction, normal wall thickness and mild dilatation. the test showed no tricuspid regurg and mild to moderate mitral regurg. i know that the increase in mitral leakage is due to the CM, but i worry about her LVEF not improving despite of 50mgs of Coreg. she was diagnosed in March of 05. thank you