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Old 05-03-2012, 11:45 PM   #1
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Ejection Fraction and BNP

I'm a 21 year old male athlete. I am fit now, but was obese as a younger child. I highly suspect I have some kind of metabolic disorder, but that is really besides the point. I have always had occasional palpitations, so I decided to try and figure out what was causing them after I got pretty scared by some more frequent ones last month. At the end of the day all my tests came back pretty good. The palpitations were just PVCs and PACs according to a Holter study. My echo showed no structural abnormalities, but it did show that my EF% was 52 and my fractional shortening was 22%. These were both a little low for someone my age, and especially for someone my age who is a healthy weight and runs 50+ miles a week. I got kind of concerned about the idea of heart failure, so I asked for a BNP test to try and rule that out. It came back completely normal at 7 pg/ml. So, I guess that is said to rule out heart failure 99% of the time. I felt a lot better about that, but I still just sort of wonder about why my EF and FS are what they are, and if there is a way to get them up. When I was younger and not a runner I suspect they were a lot lower because I used to get out of breath extremely easily. It wasn't just me being a fat little kid; I mean that didn't help, but I would end up gasping for minutes if I had to go chase down a baseball down the driveway or anything. It was really bad. Today, I obviously don't have those issues since I've transformed myself into an athlete, but I am still generally going through chronic fatigue, and compared to other people I just don't think my heart works quite as well. For example, my heart rate can skyrocket up to like 170 plus after just climbing a few sets of stairs, yet on the other hand I can run a mid 17's 5k (although everyone else who trains like I do runs far faster and smoother). Now, I guess what I'm wondering is if it is possible that I am somehow living with heart failure and just basically "beating" it because of my lifestyle. Is that even possible? When I first started looking up things about heart failure it was telling me that well over 50% of people with it die within a couple of years and they virtually all die within 5 or 6 years. Yet, most of those studies were done with really old, weak people who hadn't been physically active for years and then suddenly developed really severe congestive heart failure. Is it possible, and even somewhat clinically common for younger people to just sort of live with it for the course of a fairly normal lifespan given that they take care of themselves. Is it also possible to put heart failure into "remission" if you manage to get your systolic and diastolic function numbers up into the normal ranges? Finally, given that I'm already where I am (52% EF) just from being so physically active, if I added medicine into the equation could I end up totally normal like everyone else my age (more in the 60-65% range)? I'm probably going to end up on an ACE inhibitor or beta blocker because high blood pressure runs in my family and they found out I have it when they were doing all these other tests that came back normal, so I was wondering if further improvement of my EF% could also come paired with my blood pressure getting lowered?

 
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Old 05-31-2012, 01:23 AM   #2
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Re: Ejection Fraction and BNP

I'm 30 and have dilated cardiomyopathy no cause known.
My ejection fraction was 44% without meds. I'm now on a beta blocker for the last 2 and a half years, I was staying steady at 59% with meds and then suddenly went down to 52% w meds. So you are 52% without meds? I wouldn't worry too much but stay on top of it. They investigated and saw me a few times at the cardiologist cuz of an arrythmia I had. Turned out to be worse and heart failure. My heart jumped quickly as well on a stress test. Said it shouldn't have. Just watch it. Continue a healthy lifestyle and go from there.
Also my ex sis in law smokes, drinks tons of caffeine and she was diagnosed in 2002 and she is also overweight and only on ace inhibitor and beta blocker.
There is hope. Thank god I got to see her as an example.
Hugs

 
Old 05-31-2012, 07:30 AM   #3
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Re: Ejection Fraction and BNP

Quote:
Originally Posted by usfxc2951 View Post
... I highly suspect I have some kind of metabolic disorder, but that is really besides the point.
Why do you suspect a metabolic disorder?

In my case, I've struggled with heart failure for 25 years. I've discovered that, the healthier and well-balanced my metabolism, the more my heart failure improved.

Quote:
My echo showed no structural abnormalities, but it did show that my EF% was 52 and my fractional shortening was 22%.
What did your doctors have to say about the low EF% in the absence of any measurable heart disease or any heart rhythm abnormality other than PVCs and PACs?

How much do you trust the expertise of the echo technician?

Quote:
These were both a little low for someone my age, and especially for someone my age who is a healthy weight and runs 50+ miles a week.
50+ miles per week! Wow! That is a lot of hoofing! Congratulations on being in such great shape! Are you training for any particular event?

That's another contradiction. A low EF%, although only slightly low, and the ability to run long distances?

Quote:
I got kind of concerned about the idea of heart failure, so I asked for a BNP test to try and rule that out. It came back completely normal at 7 pg/ml. So, I guess that is said to rule out heart failure 99% of the time.
Your echo showed no damage to your heart...... no enlargement...... no thickening...... no valve disease. Unless you feel the expertise of the echo technician and the doctor that was evaluating the results, it sure looks like heart failure is out of the question. Buts.... how bad could they be? After all, you also have a perfectly healthy BNP level.

Quote:
I felt a lot better about that, but I still just sort of wonder about why my EF and FS are what they are, and if there is a way to get them up.
Well..... the ejection fraction shows how well your heart is pumping at any given time. Five minutes later, your heart might have been pumping at 60%.

Perhaps at the time you were having the echo, your heart's electrical system was not working as well as it should have, firing at the wrong time, causing the pumping to be less than what it should have been?

Buts..... then again, you did have a 24 hour holter. Nothing significant showed up on the holter summary, right? Did you get a copy of the holter summary, or any of the output from the holter?

Did you do any physical activity or exercise while wearing the holter? Did you climb any stairs, or do anything else to trigger a fast heartrate (tachycardia)?

Quote:
Now, I guess what I'm wondering is if it is possible that I am somehow living with heart failure and just basically "beating" it because of my lifestyle. Is that even possible?
Your heart is the engine of your body. If it isn't working too well, you would be limited in your physical ability and show other symptoms depending upon the severity of the damage to your heart.

But, then again, in order for a heart to fail, it needs to have been damaged, either enlarged and stretched out, or having significant damage caused by lack of oxygen due to coronary artery blockage. Your tests show neither.

Quote:
When I first started looking up things about heart failure it was telling me that well over 50% of people with it die within a couple of years and they virtually all die within 5 or 6 years. Yet, most of those studies were done with really old, weak people who hadn't been physically active for years and then suddenly developed really severe congestive heart failure.
Because of the great medications available today, like Ace Inhibitors and Beta Blockers, people with heart failure are living longer and better.

Quote:
Is it possible, and even somewhat clinically common for younger people to just sort of live with it for the course of a fairly normal lifespan given that they take care of themselves. Is it also possible to put heart failure into "remission" if you manage to get your systolic and diastolic function numbers up into the normal ranges?
The younger you are, the better chance to survive any disease.

Quote:
Finally, given that I'm already where I am (52% EF) just from being so physically active, if I added medicine into the equation could I end up totally normal like everyone else my age (more in the 60-65% range)? I'm probably going to end up on an ACE inhibitor or beta blocker because high blood pressure runs in my family and they found out I have it when they were doing all these other tests that came back normal, so I was wondering if further improvement of my EF% could also come paired with my blood pressure getting lowered?
Beta Blockers combined with Ace Inhibitors are great for heart failure, and for lowering the blood pressure and for slowing down the heart, but they come with a few uncomfortable side effects, such as tiredness, fatigue, lack of energy and weakness, among others.

The best, most effective medication for me was a low calorie, very healthy, small meal, balanced diet; combined with demanding physical exercise; avoiding heart irritants such as caffeine, cigarette smoke, vehicle exhaust, high pollen counts, allergen, volatile organic compounds, chemicals, etc.; plus very effective prescription medications.

Figured I'd respond to you and give you some things to think about.

Best of luck and health to you, and I hope that you are able to achieve your running goals!
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Greatly Improved CHF, A-Fib, HBP, Asthma:

⇒ Eliminate household items that are toxic!
⇒ Balanced, healthy, low glycemic diet
⇒ Lots of Exercise
⇒ Avoid night allergens, toxins
⇒ Coreg!

Last edited by Machaon; 05-31-2012 at 07:33 AM.

 
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