regression of hypertrophy

[vtmobile]

an article in this month's Journal of American College of Cardiology looks at severe (>3 CM) hypertrophy in some 70 HCM people over 6+ years of observation and found that regression (thinning) of the septum (heart wall) occured significantly (>0.5 cm) in almost 60% of the individuals. The idea that the heart remodels and is so dynamic is somewhat novel to cardiology, especially that HCM can regress in its severest form. this might help explain why late onset HCM generally has a much better prognosis than early onset. This issue of growth and regression raises some really interesting questions; FIRST, what causes the enlargement and more importantly, what causes it to shrink? We must understand these issues if there is ever to be a cure.

I'd love to hear from anyone who has had regression and anyone who has ideas about what might make it regress? ACE inhibitors, fish oil, statins, genetics, good luck?? Maybe some people have an idea about what accelerates the growth of the heart wall? Alcohol, age, coffeee, stress? Let me hear from you.

[Lisa Salberg]

Re: regression of hypertrophy

Regression is likely the wrong term - in many people with HCM later in life the heart walls thin and become dilated - many people are diagnosed only at this time = yet have family history of HCM upon further investigation.
ACE has been pushed by a few - and the data has proven nothing in terms of "regression", in fact it is dangerous for many with HCM to take ACE. There was an article (posted months ago) from a researcher in Colorado- who claims to have found a "switch" that remains "on" in those with HCM and that may be the cause of hypertophy and also explain why some develop the condition later in life - as the "switch" goes from "on" to "off" and then "on" again.

Best wishes,
Lisa

[bryan]

Re: regression of hypertrophy

Lisa,
I know we are all different, but whats the reason ACE inhibitors are dangerous for us with HCM?

Thanks,
Bryan

[Sarah]

Re: regression of hypertrophy

My mom's hypertrophy disappeared, but none of her symptoms went away. I think the idea that having one spot get thinner is a solution (unless it is obstructing something else) is tempting but innaccurate. The actual walls are still jumbled and other walls may still be too thick.

S

[Lisa Salberg]

Re: regression of hypertrophy

ACE stands for Angiotensin Converting Enzyme. This enzyme in our bodies activates a hormone called angiotensin. Once activated, this causes blood vessels to constrict. This results in high blood pressure and a strain on the heart.

ACE inhibitors inhibit ACE and prevent the activation of angiotensin. This results in dilated blood vessels and a lower blood pressure. Even in people with normal blood pressure, blocking the activation of angiotensin and dilating blood vessels is effective for treatment of the other conditions listed above.


SO in short ACE does 2 things that are actuually the oppisite of what we are hoping to stop - "straining the heart" and "dialating blood vessels" - the objective is to relax the heart and maintain constriction of blood flow - as vasodialation is contraindicated for those with HCM. Those with obstuction can become very symptomatic and ill with small doses.

Does this make sense? If you would like additional information please post.

Best wishes,
Lisa

[bryan]

Re: regression of hypertrophy

Lisa,
Is it worse for those who are obstructed? I myself am not obstructed, but was wondering, cause I take 10mg of accupril twice a day. I know we must all be evaluated differently, but will this or could this potentialy have some kind of effect on my heart sometime down the road?

Thanks again,
Bryan

[Amy N.]

Re: regression of hypertrophy

O.K. this brings up some questions for me. My son recently had his yearly echo. The measurements the last two years have been around 1.05. This year it went down to .96. Mind you he's only 3, but the number shouldn't have gone down - should it? Is this something to do concerned about? I didn't find out the numbers until a week after this appointment. The doctor just told us the numbers were stable. I'd appreciate any comments on the reason why it would have decreased.

Thanks,

Amy N.

[Cynaburst]

Re: regression of hypertrophy

Measurements vary from echo to echo, technician to technician, angle to angle, etc.

The difference you mentioned is very small, so it is all probably in the same margin of error, and your son has shown no change.