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How can I prevent my heart from further damage regarding concentric left ventricular hypertrophy?  Will EECP help?

Dear Doctor,
I have few questions regarding my heart echocardiography test. The results are as follows: LV size and systolic functions are normal with EF of 67%. There is mild concentric LV hypertrophy. The diastolic filling pattern is normal of the age of the patient. RV is normal in size and function. Left Atrium is normal in size. Right Atrium is normal in size and function. Aortic valve is tri-leaflet and appears structurally normal. No aortic stenosis or regurgitation. There is trace to mild mitral regurgitation. Trace tricuspid regurgitation present. Pulmonic valve is normal. Pericardium is normal. There is no pericardial effusion. IVSd 12.41 mm LVPWd 12.41 mm Lateral wall of LV is Dyskinetic at stress test.

I did both at rest and stress echocardiogram. At rest is normal and at stress it shows as above.

I am taking Ramipril 10 mg daily. I had been taking Ramipril since 15 years starting from 5 mg.

I am 65 years of age, 180 lbs with 5′ 10″ height. My BP is controlled. Systolic stay between 130-146 Diastolic between 70-88 and pulse rate between 57-70. I consider myself an active person. Walk at least 30 minutes per day with balanced diet. My question is how to prevent my heart from further damage especially to concentric left ventricular hypertrophy? Is there any way I can regress it? I received an advice for EECP also, but I am reluctant to go ahead with that. Does EECP really good and helpful to me? Please advise. Thank you in anticipation. With regards.

Submitted by Shiva from California on 10/15/2014

Answer:
by Jose Diez, MD 

Left ventricular hypertrophy or thickening of the heart muscle is a response to excess stress or workload. It can be associated with hypertension or heart valve disease. In some unusual instances, it can be related to other disease processes such as infiltrative diseases or genetic disorders.

According to your history, it seems that the most likely explanation could be hypertension. The use of medications such as ACE inhibitors, for example, Ramipril, can help to control both hypertension and the thickening – hypertrophy. Other agents that can help reduce blood pressure are calcium channel blockers, diuretics, and Angiotensin receptor blockers. Your physicians can direct the best possible combination. The goal would be to maintain the average systolic blood pressure less than 140 mmHg, the lower the better (eg 130 mmHg).

Low sodium intake and active lifestyle are fundamental.

There is no solid evidence for the role of EECP.