Does a dilated left ventricle shrink back to normal?

[jendyk]

I had congestive heart failure caused by aortic valve regurgitation. X-rays showed that my heart was enlarged. On March 4, 2010, surgery replaced my aortic valve with a bovine one. Since then I have exercised according to prescription and in May 2012, my cardiologist told me not to worry about my heart rate and exercise as hard as I feel comfortable. I have been swimming and have managed to go 2.5 km in one go.

However, I am still retaining water even though I have changed my diet have not lost any weight.

Am I stuck with the dilated left ventricle or will my heart muscles return to my normal size?

 

[Mentu]

In the same boat.

In the same boat.

J, I empathize with you as this has been my problem, too. I've had the same cardiologist since I was first diagnosed ten years ago and I've come to trust him for both his competence and being honest with me. He says that this is such an individual problem that no one can know how far the heart will go in returning to normal which, as I know, isn't all that reassuring. He told me the significant issue is that as the heart compensates for the damaged valve the walls of the left ventricle become more stiff as they thicken. The stiffness prevents the ventricle from fully relaxing during the diastolic beat when the chamber fills so less blood is pumped out on the systolic beat leading to some degree of insufficiency. The main symptom of "diastolic dysfunction" seems to be fluid retention.

My cardio thinks that a combination of exercise and drug therapy following the valve replacement are likely to improve the condition over time. In a week, I will reach the second anniversary of my valve replacement. I can tell you that the fluid retention has been reduced which seems to indicate improving heart function. It used to be believed that the benefit from an AVR would be seen in the first few months after surgery. My doctor says there is now good evidence that the heart often continues improving for years afterwards. So the answer I have is not all that satisfying but it does offer hope. What has your cardio told you. Perhaps there will be others reading your post who can share more helpful information.

Larry

 

[Julian]

It used to be believed that the benefit from an AVR would be seen in the first few months after surgery. My doctor says there is now good evidence that the heart often continues improving for years afterwards. So the answer I have is not all that satisfying but it does offer hope.

Larry

Obviously I'm no doctor but after studying the heart for a few years on my own and working in the medical field for 6 years I've noticed something about medicine and science that people tend to forget. ITS ALL OBSERVATION. Things we are taught as law in medicine change every 10 years and change in the universities.

In short I think its absurd to think that after only 3 months after valve replacement that the heart has seen all the improvement its going to get. GIVE IT TEN YEARS AND THEN WE'LL TALK sounds more reasonable than 3 months.

I know some of us don't have 10 more years and some things for whatever reason don't change after a point but coming back to reality; recovery after any heart issue takes several years not several months. DOESN'T HURT TO PRAY AND BELIEVE IN MIRACLES contrary to popular belief. :thumbup:

 

[gaz holt]

I had my AVR in January with a left ventricle size of 65mm after my 6 month echocardiograph the ventricle size has now reduced to 58mm, my surgeon expects the ventricle size to return to 45mm (normal size is 35mm). I had no heart failure, maintain a healthy weight and exercise daily with fast walking 4mph for at least 1 hour per day

 

[Optimus]

DOESN'T HURT TO PRAY AND BELIEVE IN MIRACLES contrary to popular belief. :thumbup:

I've had holes and leaking valves for 52 years. After several years of struggling with A-Fib and getting a second opinion, a botched ablation and matters made worse by a second HOLE from that, then a THIRD opinion...and a final FOURTH from which I heard again I did indeed need surgery, I can say that even MY heart size is shrinking according to my NEW Cardiologist, one I trust, after my very recent OHS.

S.

 

[RunMartin]

I saw my cardiologist a few days ago and he said my heart had returned to normal size - it was very large before surgery. I have exercised every day since leaving hospital after the AVR but I am not sure whether this was a contributing factor.

 

[JeffM]

My left ventricle was way big before my surgery as well. If not mistaken it was 8.0centimeters. Most of the remodelling took place within the first year but it has continued to remodel to the point where it and everything else that was abnormally large, including my left atrium, which my cardio thought would not remodel because it hadn't in the first year, is now a normal size. So....ahem...take heart. I beleive an exercise regimen and healthy diet are strong contributors to helping the heart remodel. Good luck with your long term remodelling project!

 

[hook]

Mine has been enlarged for the last 25 plus years. It has gone down some after a yeaar post op, but not much hope of a full recovery. A feel great and do what I want with it enlarged. The point here being you can go a long time like this; not the end of the world.

 

[Eva]

My left ventricle shrunk a lot right after surgery, and back to almost near normal after a year. In my case, it is my left Atrium that I hope it shrinks one day back to normal.

As for exercise, my cardio advised me today to only exercise as I feel without the necessity to reach a certain heart rate. He advised me to go as far as I can push myself, and to stop when I cannot keep going...no rules, no limitations!

With time, your LV may continue to shrink slowly as long as you do not have any hypertophy.

Good luck.

 

[ar bee]

same here

same here

my LV was moderatetly dilated, it took me about 6 month to return to normal and stayed like that ever since then.

Three times a week I exercise, but dont push my max HR much over 140, mostly in the 120-ies average (Polar HR monitor ALWAYS on duty)

all the best

 

[Anand65]

I had my AVR in January with a left ventricle size of 65mm after my 6 month echocardiograph the ventricle size has now reduced to 58mm, my surgeon expects the ventricle size to return to 45mm (normal size is 35mm). I had no heart failure, maintain a healthy weight and exercise daily with fast walking 4mph for at least 1 hour per day

Are you taking any medicines to help with the LV remodelling itself to normal size?

 

[Anand65]

My left ventricle was way big before my surgery as well. If not mistaken it was 8.0centimeters. Most of the remodelling took place within the first year but it has continued to remodel to the point where it and everything else that was abnormally large, including my left atrium, which my cardio thought would not remodel because it hadn't in the first year, is now a normal size. So....ahem...take heart. I beleive an exercise regimen and healthy diet are strong contributors to helping the heart remodel. Good luck with your long term remodelling project!

what medicines did you take to help with the LV remodelling itself to normal size?

 

[Patsman07]

It will go back to a normal size because your valve is fixed. It doesn't need medication. The ventricle expands because if the leak in the first place, so it is just as capable of shrinking. The heart is a muscle after all, when we put extra strain on it (due to a faulty valve) it gets bigger, a fixed valve causes less strain, so it shrinks.

I had a mechanical valve fitted a week after my 30th birthday, My left ventricle was very enlarged and was the sole reason I needed the operation then. I'm 36 now, if memory serves me correctly within two years it was back to a normal size.