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They concluded that: "Fortekor Plus had non-inferior efficacy and was associated with significantly less emesis compared to administration of Fortekor and Vetmedin in dogs with CHF caused by MMVD." In a September 2020 article -- The VALVE Study , a team of German and Swiss researchers compared treating MVD-affected dogs in congestive heart failure (CHF - Stage C) with and without the ACE-Inhibitor ramipril