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Question:

Isn't my LV mass way above limits considering my entire heart weighs only 400g? 

Doctor, my annual echo report showed some increases: LV (left ventricular) mass from 365 to 500, but LV mass/d ASE down to 365 from 391; IVSs from 16 to 24, SWTd and IVSd remained at 15. All other values in normal limits. AOV went from 17 to 23. Concentric LVH (left ventricular hypertrophy) with mild dilation. Mild aortic & tricuspid valve insufficiency. I am a 75 year old male, controlled BP 105/65, healthy lifestyle, 5'11, 180lb, 2 stents, pacemaker, taking Xarelto, Coreg, Amiodarone. Isn't LV mass extreme and way above limits, considering my entire heart weighs only 400g? Will Losartan, Amlodipine help? Thanks. 

submitted by Gerhard from South America 1/6/2014

Answer:

Raymond F. Stainback, MDby Texas Heart Institute cardiologist, Raymond F. Stainback, MD    

LV mass can be increased from a variety of causes, the most common of which is hypertensive heart disease. You indicate that the blood pressure is normal range currently. It is important to realize that technically, the measurement of LV mass is challenging and can vary from study to study. Therefore, it would be important to know if the exam was repeated by the same technician in the same lab with the same quality images to see if there is a real difference in wall thickness and mass or variability in measurement technique. The important thing is knowing that the wall thickness and / or mass are increased in the first place. Then, treatment can be implemented. Angiotensin Receptor blockers and Angiotensin converting enzyme inhibitors have been associated with improvement in LV mass, especially if there is high blood pressure with inadequate treatment. 

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Updated January 2014
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