Question for Dr. Fett

[jenp]

Hi Dr. Fett,
When I was dx in 5/2008 my EF was 40%. On 6/2009 (1 yr post delivery) my repeat echo was 50.9%. My cardio wanted to get an MRI to see if there was any scarring etc and to give any clues as to why my EF wasn't "normal". The MRI showed LVEF 64%!!!
I'm obviously very happy, but slightly confused. Why would there be such a difference in the numbers? She explained that the echo only shows one view and the MRI shows a more accurate picture, is this true? Should I believe what the MRI shows as opposed to the echo?
Also, does this mean that from now on I should get cardiac MRI's to determine my EF?
When determining the EF from an echo, do they use you blood pressure in any part of the "math"?
Thank you so much!
I'm so thrilled!

[JAMESFETT]

I rely upon the echocardiogram as an indication of trends over time. The MRI is not the test of choice to determine LVEF; is much more expensive and as a measure of LVEF may be no more accurate or not even as accurate. Did your MRI show any abnormality of the gadolinium enhancement? Enhancement at 10 minutes can indicate fibrosis or scarring. Let us presume that your LVEF is somewhere between 51 and 64, those are good numbers, and represent solid healing. On the lower side, not yet fully recovered, and on the upper side compatible with full recovery. B.P. does not determine the results. You are only 14 months post-diagnosis, so you still have time for more recovery, and I expect you will eventually have that. Modern echocardiography is two- and three-dimensional.

JD