Author(s): Mundal Sureswara Reddy, Picholla Venkata Ramana, Shaika Reshma, Sathyala Susmitha, Danish Ahmed Khan, Kandula Ravindra Reddy

BACKGROUND Metoprolol has beneficial effects in congestive heart failure, it binds with beta adrenergic receptors of brain, heart, kidney there by it will reduce sympathetic neurotransmitters release, decreases heart rate, force of contraction and cardiac output, decreases renin hormone release from the kidneys. By these three actions it will reduces pre load and after load on heart. It directly opens specific L-type of membrane calcium channels in heart and also glycogenolysis which leads to increase in pumping capacity of left ventricle, there by heart will meet various metabolic demands of the body. Aim- To provide Safe and effective management for congestive heart failure patients by adding metoprolol (selectiveβ1 blocker). MATERIALS AND METHODS 6 minutes walking test, chest X-Rays, ECG, 2 D-Echo and other required investigations are conducted for validation of beneficial effects of metoprolol in improving ejection fraction at base line and also at follow up by using various study materials in four months duration. Over 2.4 million patients who are hospitalized have HF as a primary or secondary diagnosis, and nearly 300,000 deaths per annum are directly attributable to HF. Statistical Analysis- Data was articulated in percentage. Design - A concurrent interventional cohort study. RESULTS A total of 70 patients were recruited; among that, 50 patients were test and 20 patients were standard. Exercise capacity and ejection fraction of test group patients and standard group patients was estimated and improvement in ejection fraction, exercise capacity was observed in test group compared to standard group at first (0.92%), (0.72 min) and final follow up (3.74%), (3.24 min) respectively. Statistically significant difference was observed in ejection fraction (< 0.05) and exercise capacity (< 0.05) test group, but not in standard group (E.F.- 0.067, E.C.- 0.079). Also found improvement in chest X-ray, ECG at base line Vs final follow up. CONCLUSION Metoprolol use in congestive heart failure- increases left ventricle ejection fraction, exercise capacity, anti-remodeling effect by decreasing myocardial apoptosis and also reduces cardiac disability frequencies, prevents long term complications, reduces morbidity and mortality. For providing better patient care to CHF patients there is a need to add metoprolol.