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Abstract

THE COMPARISON OF SHORT TERM MONOTHERAPY AND COMBINATION THERAPY OF RAMIPRIL AND METOPROLOL IN THE MANAGEMENT OF LEFT VENTRICULAR SYSTOLIC DYSFUNCTION

Neethu Krishnan*, Anjana Raj, Gopika A. and Dr. Ram Naresh Allam

ABSTRACT

Objective: To compare the short term monotherapy and combination therapy of Ramipril and Metoprolol in the management of left ventricular systolic dysfunction (LVSD). Methods: This prospective observational study entitled “Comparison of short term monotherapy and combination therapy with Ramipril and Metoprolol in the management of LVSD” included patients with LVSD with ejection fraction (EF <50%). We identified all patients with LVSD and advised ECHO, from which baseline data were obtained. Selected patients were randomly divided into 3 groups. Group A received Ramipril (2.5-5mg), Group B received Metoprolol (25-50mg), Group C received combination of both (2.5 mg Ramipril+25 mg Metoprolol). After 2months changes in ejection fraction was recorded by echocardiography screening and the effect was determined based on the improvement in EF. Results: Results showed that Diabetes Mellitus (DM) (74%), Coronary Artery Disease (CAD) (56%), Hypertension (HTN) (54%) were probably dominant factors in the progression of LVSD. Baseline EF of Ramipril (33.31%) increased to 34.75% at second review with mean difference of 1.4%. For Metoprolol, baseline EF was 29% and it increased to 30.73% at second review with mean difference of 1.7%. At the same time, EF of combination of both increased from 33.25% to 35.36% with a mean difference of 2.1%. Conclusion: The most common risk factors associated with LVSD were DM, CAD, and HTN. Combination therapy with Ramipril and Metoprolol increased the ejection fraction more effectively than monotherapy with Ramipril or Metoprolol in this short term study.

Keywords: Left Ventricular Systolic Dysfunction, Heart Failure, Ramipril, Metoprolol, Ejection Fraction.


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