Cardiac Left Ventricular Hypertrophy on TRT

[Tommy Wall]

I made ECG, stress test and Dopple ultrasound. I when I handed in the results to the secretary I was informed that if something is wrong they would call me otherwise I could pick the results up in 5 days. No one called and I picked the results up. I was a bit curious so I read everthing that the doc that made the doppler had written. Everything was normal but there was a line that made me worried. Slight /light cardiac hyperthrophy ventricular. But my GP didn´t say anything about it. My GP knows I´m working out and I don´t know if that can cause this. Shall I worry?

 

[Tommy Wall]

Any input on this?

 

[Vince]

Luckily it's only slight. I believe is caused by high blood pressure and of course being overweight contributes.

 

[madman]

I made ECG, stress test and Dopple ultrasound. I when I handed in the results to the secretary I was informed that if something is wrong they would call me otherwise I could pick the results up in 5 days. No one called and I picked the results up. I was a bit curious so I read everthing that the doc that made the doppler had written. Everything was normal but there was a line that made me worried. Slight /light cardiac hyperthrophy ventricular. But my GP didn´t say anything about it. My GP knows I´m working out and I don´t know if that can cause this. Shall I worry?

https://onlinelibrary.wiley.com/doi/full/10.1111/jch.12977

Conclusions

Even though both hypertensive patients and athletes can develop LVH, there are several structural and physiological differences between the two. That the LV hypertrophies are a function of chronically or intermittently elevated BP is suggested by the aforementioned findings, which show that both fit hypertensive patients and relatively fit individuals are not likely to achieve systolic BP ≥150 mm Hg necessary to stimulate cardiac remodeling during normal daily activities and, therefore, an increase in LVM is not likely. For those with existing LVH, regularly performed aerobic exercise of moderate intensity improves fitness and lowers BP at absolute workloads and the daily hemodynamic load, as is reflected by lower BP. Consequently, the daily exposure to a substantially lower hemodynamic load removes the impetus for cardiac remodeling and eventually leads to LVM regression.

 

[Nelson Vergel]

LV hypertrophies are a function of chronically or intermittently elevated BP

After years of trying different hypertensive medication protocols, I was able to conquer LVH!

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ECHO March 2024: Mild Abnormalities​

• Heart Size: The left ventricle (main pumping chamber) was a bit thickened. This is called left ventricular hypertrophy, often due to high blood pressure or long-term strain.
• Pumping Function (Ejection Fraction/EF): 62% — still within the normal range, but on the lower end.
• Diastolic Function: Mild stiffness in the heart muscle, called grade I diastolic dysfunction, meaning the heart didn’t relax quite as easily as it should.
• Left Atrium: Mildly enlarged — this can result from the stiff heart muscle and increased filling pressure.
• Heart Valves: Mostly normal, with very mild (trace) leakage seen in the mitral and tricuspid valves — not clinically significant at this level.
• Right Heart: Right ventricle and right atrium were normal.
• Conclusion: The heart was pumping adequately but showing early signs of stress, likely related to chronic conditions such as high blood pressure or lipid issues.

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ECHO May 2025: Normal​

• Heart Size: All chambers returned to normal size.
• Pumping Function (EF): Improved to 67% — strong and healthy.
• Heart Muscle Thickness: Normal (LV wall thickness IVS = 0.9 cm, PW = 0.8 cm).
• Diastolic Function: Normal — the earlier stiffness appears resolved.
• Heart Valves: All functioning normally. No leakage or narrowing.
• No fluid around the heart or lungs.
• Conclusion: Heart structure and function are now within normal limits.

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Key Differences​

Feature	ECHO March 2024	ECHO May 2025
EF (Ejection Fraction)	62%	67%
Left Ventricle	Mild thickening	Normal
Diastolic Function	Grade I dysfunction (stiffness)	Normal
Left Atrium	Mildly enlarged	Normal
Valve Function	Trace leakage in mitral & tricuspid valves	No leakage
Overall Impression	Mild structural stress	Normal heart function

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What This Suggests​

The March 2024 echo showed early signs of the heart working harder than usual, possibly due to high blood pressure or metabolic factors. However, the May 2025 echo shows meaningful improvement — no more stiffness, normal chamber sizes, and stronger pumping efficiency.
This improvement might reflect:

• Better blood pressure control
• Lifestyle changes
• Effective medications
• Reduced cardiovascular strain

 

[madman]

After years of trying different hypertensive medication protocols, I was able to conquer LVH!

---

ECHO March 2024: Mild Abnormalities​

• Heart Size: The left ventricle (main pumping chamber) was a bit thickened. This is called left ventricular hypertrophy, often due to high blood pressure or long-term strain.
• Pumping Function (Ejection Fraction/EF): 62% — still within the normal range, but on the lower end.
• Diastolic Function: Mild stiffness in the heart muscle, called grade I diastolic dysfunction, meaning the heart didn’t relax quite as easily as it should.
• Left Atrium: Mildly enlarged — this can result from the stiff heart muscle and increased filling pressure.
• Heart Valves: Mostly normal, with very mild (trace) leakage seen in the mitral and tricuspid valves — not clinically significant at this level.
• Right Heart: Right ventricle and right atrium were normal.
• Conclusion: The heart was pumping adequately but showing early signs of stress, likely related to chronic conditions such as high blood pressure or lipid issues.

---

ECHO May 2025: Normal​

• Heart Size: All chambers returned to normal size.
• Pumping Function (EF): Improved to 67% — strong and healthy.
• Heart Muscle Thickness: Normal (LV wall thickness IVS = 0.9 cm, PW = 0.8 cm).
• Diastolic Function: Normal — the earlier stiffness appears resolved.
• Heart Valves: All functioning normally. No leakage or narrowing.
• No fluid around the heart or lungs.
• Conclusion: Heart structure and function are now within normal limits.

---

Key Differences​

Feature	ECHO March 2024	ECHO May 2025
EF (Ejection Fraction)	62%	67%
Left Ventricle	Mild thickening	Normal
Diastolic Function	Grade I dysfunction (stiffness)	Normal
Left Atrium	Mildly enlarged	Normal
Valve Function	Trace leakage in mitral & tricuspid valves	No leakage
Overall Impression	Mild structural stress	Normal heart function

---

What This Suggests​

The March 2024 echo showed early signs of the heart working harder than usual, possibly due to high blood pressure or metabolic factors. However, the May 2025 echo shows meaningful improvement — no more stiffness, normal chamber sizes, and stronger pumping efficiency.
This improvement might reflect:

• Better blood pressure control
• Lifestyle changes
• Effective medications
• Reduced cardiovascular strain

Glad to hear Nelson!