What Steps Can Be Taken To Improve A High LVID ?

Posted on Sat, 3 Sep 2022

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 3 Sep 2022 Answered on

Fri, 4 Oct 2024 Last reviewed on

Question : I am a 62 years male with hypertension & IGA nephropathy for the past 12 years which is being treated with Cardace 10 mg, Stamlo 5 mg, Lipitor 10 mg, and fish oil capsules. In addition I have a benign prostrate (Grade 2) since July 2016- tablet urimax 0.40 mg since April 22, and multiple thyroid nodules (largest on left & right side each 0.81mm x 0.50 cm, no medication). BP is around 130/80.

I attach my latest Echo report of August 2022 and my previous Echo in July 2019. My queries on the Echo are as follows:

1. Please review the Echo reports and advise if the reports are normal.

2. The Echo report does not mention the reference range for the various dimensions taken for LV, RV, etc. What are the XXXXXXX Echo reference values for the following : LVID(ed), LVID(es), LVPW (ed & es), IVS (ed & es).

3. In order to determine Left Ventricular Hypertrophy (LVH), which dimension values are taken into consideration ?

4. My LVID(ed) was 4.7 cm in July 2019 and increased to 5.1 cm in August 2022. Is this a cause for concern? What could be the reason for such an increase ? Could the variation in dimension be partly due to the Echo operator variability while taking the measurements?

5. What steps can be taken to improve a high LVID ? I would like to reduce the LVID (ed) from 5.1 cm.

Thanks

Answered by Dr. Bhanu Partap (17 hours later)

Brief Answer:
Kindly refer to the information below

Detailed Answer:
Hello

After going through the medical query raised by you I can understand your concern I would like to address to your queries as follows

1. Yes, both your old and new echo reports are within normal limits.

2. Kindly check this pdf for reference values
https://reader.elsevier.com/reader/sd/pii/S0000?token=E7DD9077C282A36D475B2D94B18D9759B7C3857F370A499AF68BE400B24E1F38ACD8656DFB0671B2D8C56D2A43A213C8&originRegion=eu-west-1&originCreation=0000

3. For LVH thickness of IVS and Posterior wall in diastole is measured. Reference value you can find in pdf.

4. Yes, the change in your measured values is quite likely due to user variations.

5. That is done with the help of certain cardiac medications. But this is not required in your case.

I hope this information will answer all your queries.

For more basic and useful health information you can visit www.healthmonastery.com

Kind Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Bhanu Partap (23 hours later)

Thank you for your prompt and informative response.

1. The reference you have given states that XXXXXXX LVIDd range is 39.8 -42.4 mm as against the ASE range of 42 -58 mm. My earlier LVId was 47 mm and current is 51 mm - viewed against thIis XXXXXXX range values my LVIDd at 51 mm is out of range. Please let me have your views on this.

2. The reference you have given does not have the range for IVS and Posterior wall in diastole -could you let me know what the ranges for these are?

3. My unindexed LVIDd is 51 mm. My height is 164 cm and weight 62 kg. What would be my BSA indexed LVIDd ?

4. Do XXXXXXX labs currently use the ASE reference ranges for deciding normal range values in an Echo e.g. they would be using 42-58 mm as the normal range for LVIDd?

Thanks

Answered by Dr. Bhanu Partap (6 hours later)

Brief Answer:
Hello again

Detailed Answer:
Due to lack of sufficient research and standardisation there is no recommended reference to follow for Asian population.

In majority of the centres XXXXXXX and European standards are followed.

For consideration of LVH normal IVS and posterior wall thickness range for diastole is 0.9to 1.2

In your particular case I would suggest you to repeat an echo after 6 months.

Regards

Above answer was peer-reviewed by : Dr. Dr. Yogesh D

Follow up: Dr. Bhanu Partap (3 hours later)

Hi -thanks for your response.

Any particular reason for your recommendation to repeat Echo after 6 months ?

Answered by Dr. Bhanu Partap (9 hours later)

Brief Answer:
Hello again

Detailed Answer:
Just to make sure that the dimension size change is a operator variation.

Regards

Above answer was peer-reviewed by : Dr. Saisudha Kotla

Follow up: Dr. Bhanu Partap (3 hours later)

If I redo the Echo and there is no change in the LVIDd dimension size from 5.1 cm, what does it mean ?
Does it mean there is an issue with my heart, and if so what next steps do I need to take ?
Thanks

Answered by Dr. Bhanu Partap (11 hours later)

Brief Answer:
Hello

Detailed Answer:
If the LVEDD goes beyond 5.2 then we probably need to start some medications.

Regards

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Raju A.T