ef 20%

hi doctor  my father had heart attact 16 years ago and 10 years ago he had gone under angioplasty and 6 months before he was gone under  bypass surgery because of breathlessnes . stress eco report shows that lvef is 20 to 25% and left arteruim has damaged and it need a bypass surgery  because there is 98% blokage in three artries and he is diabetic . and succsess ful bypass surgery  has done . now my qestion is there is posibuilty of improvement of lvef from 25%to 35 or 40%. and doctor has advised him  'lantus' insulin 20 unit before breakfast.is this insulin is nesserly be taken.

[ed34]

It all depends on the amount of irreversible tissue damage. It also depends on their reasons for bypass surgery. Was it (a) because the blockages were now affecting areas of the heart that were not affected by the initial heart attack, to prevent things getting worse. or (b) they felt that some tissue damaged by the heart attack could be reversed in condition.
You ask if there is a possibility of improvement from 25% to 40% but to be honest, nobody can answer that question, even a cardiologist. Different people improve in different ways and some people who are expected to improve do not, while some who are expected not to improve do so dramatically. It is virtually impossible to predict long term outcomes. What the cardiologist will probably do is another echo in 6 months, and then you will see if there is any improvement. However, I would like to emphasise about EF. Don't gear all your measurements around this because the most important thing is how your father feels and what his quality of life is like. For example, Someone with 50% EF and no heart problems can feel much better than someone with 70% EF and lots of disease. I have 70% and couldn't even walk up a flight of stairs without a lot of pain. So, EF is not everything.
I believe there is a blood test which can establish the functionality of the left ventricle fairly accurately, I think it's a BNP test. The left side of the heart secretes chemicals which play a part in how much blood we produce to fill our body. The more the heart struggles, the more chemicals it secretes to have more blood manufactured to assist it. I'm not very up on this side of it, but perhaps someone else here can explain the blood test further.

Take care

[kenkeith]

QUOTE:"now my qestion is there is posibuilty of improvement of lvef from 25%to 35 or 40%. and doctor has advised him  'lantus' insulin 20 unit before breakfast.is this insulin is nesserly be taken".

>>>I had a silent heart attack (ischemic..lack of blood flow), and my EF was 13% with a cath and <29% with an echo.  The opening of a vessel with good blood supply can increase the EF. Curently, my EF and heart size is normal with medication although I have a totally blocked atery (developed other vessels to supply the deficit) and a 72% blockage of another vessel and don't need any further treatment save medication..  

Your farther has gone through a procedure to supply to the location that may have heart cells that impaired heart wall movement (hypokinesis) and some of those damaged cells can be revitalized and improve the heart's ability to pump more blood.  This will increase the EF.  

To further evaluate the probability of an increase in your father's EF, I would need more information such as the echo report of left ventricle size, atria sizes, heart wall dimensions, and if there is any structural anomolies.  Also, when and what tests have been performed.  Any other concomitant health issues other than diabetes?

Thanks for sharing your father's medical experience, and feel welcome to ask questions on this thread or you can Email me.  Take care.

[kaka123456]

thank you very  much for your answer