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Updated: Aug 10, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Felodipine improves left ventricular emptying in patients with chronic heart failure: V-HeFT III echocardiographic
M Wong1, T Germanson, W R Taylor
1VA Greater Los Angeles Healthcare System, West Los Angeles Division, California 90073, USA.
Insights
Adding felodipine to heart failure treatment improved left ventricular ejection fraction (EF) and function. This study confirmed echocardiography
Area of Science:
- Cardiology
- Pharmacology
- Medical Imaging
Background:
- The Vasodilator-Heart Failure Trial III (V-HeFT III) investigated felodipine's effects in heart failure patients on ACE inhibitors.
- Previous trials showed benefits of hydralazine-isosorbide dinitrate and enalapril on ejection fraction (EF) and survival.
Purpose of the Study:
- To assess if felodipine, combined with ACE inhibitors, improves left ventricular (LV) structure and function in heart failure.
- To evaluate the additive effect of a potent vasodilator (felodipine) to enalapril therapy.
Main Methods:
- Doppler-echocardiography data from 260 male heart failure patients randomized to felodipine or placebo.
- Intrasubject differences analyzed at baseline, 3 months, and 12 months.
- Reproducibility assessed using duplicate recordings and readings.
Main Results:
- No significant changes observed at 3 months in either group.
- At 12 months, felodipine group showed increased EF, shortened LV end-systolic length, and increased stroke volume index.
- Reproducibility coefficients of variation were 7.4% (EF), 6.0% (end-diastolic length), and 13.0% (stroke volume index).
Conclusions:
- Felodipine, when added to heart failure therapy, enhanced EF, reduced end-systolic length, and increased stroke volume index.
- Observed changes were modest.
- Multi-laboratory echocardiography coordination proved effective for research.
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.
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