Felodipine improves left ventricular emptying in patients with chronic heart failure: V-HeFT III echocardiographic substudy of multicenter reproducibility and detecting functional change

Maylene Wong, Terry Germanson, W. Robert Taylor, Ira S. Cohen, Gilbert Perry, Lawrence Baruch, Prakash Deedwania, Becky Lopez, Jay N. Cohn

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background: The echocardiographic substudy of the Vasodilator-Heart Failure Trial III (V-HeFT III) aimed to determine if felodipine treatment in patients with heart failure who were taking an angiotensin-converting enzyme inhibitor had a favorable effect on left ventricular (LV) structure and function. Earlier V-HeFT trials showed that hydralazine-isosorbide dinitrate improved ejection fraction (EF) and survival, whereas enalapril achieved greater survival with smaller increases in EF. Would the combination of a potent vasodilator and enalapril produce greater improvements in function and survival? Methods and Results: Doppler-echocardiographic data were collected from 260 males with heart failure who were randomized to felodipine or a placebo. Mean intrasubject differences between baseline, at 3 months, and at 12 months were compared. Intersite and intrareader reproducibilities were measured from duplicate recordings and readings. At 3 months, no changes in ultrasound variables from baseline occurred in either group. At 12 months, felodipine patients achieved greater increases in EF, shortening of LV end- systolic length, and increases in stroke volume index. Reproducibility coefficients of variation were 7.4% (EF), 6.0% (end-diastolic length), and 13.0% (stroke volume index). Conclusions: The echocardiographic substudy showed that felodipine, added to heart failure therapy, increased EF, shortened end-systolic length, and increased stroke volume index. The changes were small and confirmed that reproducibility from multiple laboratories can be coordinated into a useful research tool.

Original languageEnglish (US)
Pages (from-to)19-28
Number of pages10
JournalJournal of cardiac failure
Volume6
Issue number1
DOIs
StatePublished - Jan 1 2000

Keywords

  • Echocardiography
  • Left ventricular emptying
  • Reproducibility
  • V-HeFT III

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