Enlargement

[Yvonne]

I just read in another thread something about enlargement. I started 8 months ago with a slight enlargement and a low EF (15%). The echo's after the first one showed an increase of left ventrikulair size, but also an increase of EF. The increase of size really scared me, but on the other hand I think an increase of EF is more important. Can it be a temporarely increase of size caused by remodelling? I hope the answer will be postive, it should take a lot of my fears away.

[JAMESFETT]

Yvonne--the left ventricle (LV) function (EF) is more important than the LV size. Also the size should be geared to the body surface area, and the "normal" LV size is < 2.7 cm/body surface area. (a measure adjusted for height and weight, since a LV diameter of 4 may be normal for some persons but not normal for smaller persons. It is not often clearly understood that this word "remodeling" denotes a less efficient shape to the left ventricle. Remodeling happens in heart failure (HF), but it is not necessarily a desirable happening. In fact, scientific evidence exists showing that certain medications acturally prevent remodeling, and thus help to preserve the most efficient shape of the left ventricle. Among those medications is carvedilol (Coreg). For practicle purposes PPCM patients don't need to be concerned about LV size, but they do need to be concerned about LV systolic function (EF). Consult your cardiologist for others.

James