LVEF (left ventricle fraction ejection) question

[DianneS]

What is a normal figure for the LVFE, I believe it is called? They do an echocardiogram on me every 3 months as I am on Herceptin and have been since November. I got a 70 last time (February 09) and wondered what is optimal, normal, subnormal, etc. Does anyone know?
Thanks,
Diannes

[Rich66]

I'd like to know this as well. Also, are MUGA and ECG equivalent for LVEF evaluation? Dianne, was there mention of why ECG was done instead of the more common MUGA?

[DianneS]

Hi Rich,

I don't know if MUGA's and echocardiogram equivalents for LVEF are the same - anyone know?

No, no mention was made why I got an echocardiogram rather than the MUGA, although I'm glad I did - sounds less invasive. We have the 3-D echocardiogram Dopplar which seems to pick everything up. I live in Canada as well, so maybe that's a factor?

Diannes

[Laurel]

I receive echos every 3months. My LVF has been as high as 65 and is now holding (just had one on Friday so keeping fingers crossed) at 55. Just like a muga they do not want you to fall below 50 or have a 10 pt drop from one echo to the next, as in 65 dropping to 55. A 70 sounds pretty outstanding to me!

[chrisy]

"normal" for LVEF is between 50 and 65. What they are watching for with the monitoring is a significant drop, or a decrease below the normal range. Over the past 5 years, mine has fluctuated a lot, from 53 to 78. And sometimes I have had reports that just called it "normal".

An echo and a muga both measure LVEF, but in different ways. Echo measures the physical dimensions of the left venticle as it contracts and expands. Basically it's an ultrasound of your heart pumping. Muga measures the flow of the blood.

One thing you should be aware of, especially with the Echo, is that it is "art as well as science" and is dependent upon the skill of the tech that does the test. So it will fluctuate.

My onc told me that there wasn't much I could do to impact it other than the normal things you do to maintain a healthy heart - exercise, good diet, etc. Lots of people also take CoQ10 supplements but you should always clear anything you take with your doctor.

But 70 is pretty darn good.

[PinkGirl]

A echocardiogram (echo) uses ultrasound waves to image the contractions of the wall of the heart. It is a 2 dimensional image of a 3 dimensional object. A multigated analysis (MUGA) scan is a nuclear scan that measures the changes in nuclear counts in the heart over a period of time. Normal ejection franction is between 50 and 75%.



Of the two tests echo is more subjective and is more dependent upon the skill of the individual doing the study and the experience of the reader. A MUGA scan is less open to error although they can still occur.

[Debbie L.]

I'm going to have to start taking notes when I listen to these podcasts. I don't remember who said it, but it was some expert-or-other, discussing cardiac effects of adriamycin and/or herceptin. He said that they had long term data including all the mugas during treatment for a large group of women, and that they could not correlate LVEF drops with later onset of congestive heart failure. Some who developed CHF later had fine LVEF's during treatment, and vice versa.

He also claimed that if someone exercised (or even dashed in from the parking lot) before going in for the MUGA, they would have an artificially-elevated LVEF and then if they rested before the next one, it would appear that heart function had dropped when in fact it had not. (he did not seem to be a big fan of LVEF tracking).

Go figure. And while we're on cardiac questions - does anyone know why they seem unworried about cardiac effects with T-DM1? I thought that the reason Herceptin could affect the heart was because the heart has a significant number of HER2receptors. So if the T-DM1 is going there and releasing lethal chemo - wouldn't that be an issue? Obviously they'd have mentioned it if they thought it was a concern so there must be something faulty in my logic. Does anyone know the answer?

Debbie Laxague