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


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.
Wong
M
M
VA Greater Los Angeles Healthcare System, West Los Angeles Division, California 90073, USA.
Germanson
T
T
Taylor
W R
WR
Cohen
I S
IS
Perry
G
G
Baruch
L
L
Deedwania
P
P
Lopez
B
B
Cohn
J N
JN
D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002908:Chronic Disease; D018618:Echocardiography, Doppler, Color; D015736:Felodipine / Q000627:therapeutic use*; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000401:mortality; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D006801:Humans; D008297:Male; D015588:Observer Variation; D011237:Predictive Value of Tests; D020127:Recovery of Function / Q000187:drug effects*; D015203:Reproducibility of Results; D015996:Survival Rate; D016277:Ventricular Function, Left / Q000187:drug effects*
D002121:Calcium Channel Blockers; D015736:Felodipine