MILD LVH, IVS 1.2 cm . . . worrisome or not?

[andrewa]

56 year old male, great shape.  Do high intensity interval training three times a week . . to point of exhaustion.

Had a recent stress-echo at Cleveland Clinic.  Told over the phone that results were “excellent” but upon obtaining a copy of the results see that the echo evidenced mild LVH.  I do NOT have high blood pressure so I assume this is from the intense exercise and an athletic heart.  So now what?  If I keep up the intense exercise, can this get worse?  Do I need to cut back to allow heart to go back to normal? Online, there seems to be conflicting evidence between the medical community as to whether this is something to be concerned about.

[andrewa]

I know exactly what you mean.  When I work out at 85% mhr, it hardly feels like I am working out at all.  I love the way I feel after the high itensity exercise.  I love the way I feel the rest of the day.  Still, not going to risk more thickening . . . so. . .

[erijon]

I know what you mean. I too was told to cut back as there was no additional benefit to exceeding 90% of max. It just didn't seem like a workout at that level so I have slowly crept back up. I'm sure my doctor would tell me to back off again if he knew.

I just like that feeling of exceeding my max heart rate and pushing as many mets as possible, but it really doesn't do much good, it's just all in our heads I'm afraid.

Good luck, just keep it within limits and I'll try the same!

Jon

[andrewa]

Well word from the doctor  today was stop with the high intensity interval training.  Working myself to exhaustion is not doing my heart any benefit.  Keep exercising, just less intensely.  Can’t say I am glad to get this advice and it is contrary to all of the good things I read about high intensity interval training online, but suppose with a thickening heart I should listen.  Maybe I will repeat the ECHO in six months and see if things have gotten better.

[lesha1979]

i am currently scared to go to the gym.  i used to work out on a regular but since this started happening i dare not.  as soon as i start doing any activity my heart speeds up quickly n high speeds, funny though cuz its not everyday or every time.  what to do!!??

[erijon]

My cardiologist told me to keep exercising. She also said that it was not dangerous and would remodel itself back to normal. Where you run into issues is with concentric global hypertrophy in which the entire left ventricle gets too thick to function properly. Your reading was the septal wall separating your right and left ventricle.

Personally, I cycle 12-15 miles per day and have peak runs up to 12 mets or more and 100% plus of my max for short periods. I have been told that if my heart function was compromised by hypertrophy, it would be impossible to exercise at that level.

Good luck,

Jon

[andrewa]

Thanks Jon.  I suppose I am concerned about whether it is still a good idea to continue with the intense exercise, which normally gets my heart rate up to 100% of max by the last interval or so, and has me very short of breath until a minute or two of recovery.  Does the LV continue to thicken under those circumstances?  And at what point does it possibly cause irreversable damage?  Does medicine really know the answer to this?  My ejection fraction was fine, measured at 60% and everything seemed to be within normal limits except for Fractional Shortening, measured at .48 while normal is .18 - .42.  I think this is good but not sure, and LA Systolic Diameter was 4.1 cm with normal 1.9 - 4.0.  I guess I will try to get through to the Cardiologist who ordered the exam.  He seems like a good guy and very knowledgeable.

[erijon]

You and I are in the same boat, I too exercise fairly intensely and have a measurement of 1.2 cm. A couple things, first what is normal and what is high is based on the lab. Many labs call 1.3 cm high and 1.2 cm normal. There is no real concern until it reaches 1.5 cm so you are a long ways from that.

My cardiologist says it is within a normal variant and is most likely due to the amount of exercise I do. As long as wall motion is normal, there are no other symptoms, blood pressure is controlled and you have a healthy EF%, 1.2 cm is really nothing to worry about. I asked if I needed to follow up and was told only if I have a change like a decrease in exercise tolerance or symptoms of heart disease. That was 5 years ago, still going strong.

Also, keep in mind that many of the measurements on an echo are an estimate depending on the picture quality so it may not even be an issue. If you were told everything  was excellent, I would go with that.

Hope this helps,

Jon