Left ventricular hypertrophy

I had an echocardiogram in January of 2010.  The conclusions on the report by the cardiologist were left ventricular hypertrophy, beginning states of diastolic dysfunction, trace tricuspid and mitral regurgitation.  The ejection fraction was estimated at 75%.  I know LVH is not good and diastolic dysfunction is not good.  My valves are ok.  I have hypertension and take Lotrel 10/20 and hydrochlorthiazide 25mg. I also had a nuclear adenosine stress test recently.  The results of this test showed an area of reduced counts in the inferior wall after administration of adenosine and at rest.  The ejection fraction was estimated at 49%. At the time of this test I was taking 25 mg of metoprolol in addition to the Lotrel and hydrochlorthiazide.  I am thinking that the ejection fraction may have been lower due to this beta blocker, since it was 75% on the echo in Jan.  The cardiologist said the test was ok.  Could anyone give me more insight to this.

[Jerry_NJ]

On the EF matter, I note 75% is on the high end of "normal", higher is not better once one gets up to 70% (best I can remember), and 49% is just fine, low end of normal.  The left ventricular hypertrophy could be the reason for the high EF (75%) not sure what to make by comparison of the 49% reading.  I've gotten considerably different readings on the diameter of my left atrial (important for my AFib problem) and my cardiologist has never give an answer for why... all measures were made by the same technician. Unfortunately for me, the enlarged left atrial seems to be the correct reading and thus I continue to suffer from AFib with not much hope to cure it.  

I have never been told anything about beta blocker effects of EF... I have an EF of about 60% repeated in several echocardiograms.  I think it is common for different methods of measure of EF to give different results - but I don't know anything about EF measurements from stress tests, I've had a few of those too.

[Bromley]

What I would wonder about is how these two measurements were taken. Seems like some of the common techniques may use a 2-D imaging technique, while more modern instruments may use 3-D. If 2-D, what assumptions have they got to make to get to chamber volume, and how reliable could the resulting ejection fraction be?

There is an article on emedicine regarding the effect of beta blocker on ejection fraction. Might not exactly line up with your situation, but may be of interest:

www.medscape.com/viewarticle/562472