Efficacy of Isosorbide dinitrate and Hydralazine combination in non ischemic dilated cardiomyopathy in a tribal based population at a tertiary care hospital

Non ischemic dilated cardiomyopathy is an important cause of heart failure and cardiovascular mortality. Numerous pharmacologic therapies have been applied from the ancient era for treatment. Some of them have shown improve morbidity. From various literatures it was concluded that combination therapy with H-ISDN in addition to conventional medicines are very effective in black population group. In our study we have tried to establish the efficacy of fixed dose drug combination (Hydralazine + Isosorbide dinitrate) to alleviation of heart failure symptoms and mortality benefit if any. : Patient in NYHA 3 or ambulatory class 4 were included in study. Total two hundred populations were included in the prospective study. One hundred patients were treated by conventional optimum medications for heart failure including ACE inhibitors, ARBs. One hundred patients were given ISDN+Hydralazine (fixed dose) in addition to conventional medicines.: Mean age of study and controlled group was 62.5 years and 61.4 years respectively. Base line mean ejection fraction in control group was 33% and study group was 33%. After a mean one and half year follow up 61% of patient population achieved NYHA 2 in case group and 53% in control group. We assess the NT pro BNP level in both group of population at baseline and every six month interval. There is significant reduction in BNP level in study patients. 72% achieved below baseline cut off value for the age in control. In control population 51% achieved the estimated BNP value cut off for age. : Significant scope remains to improve the outcome for these patients through research related to use of H-ISDN in heart failure patients.