HEMODYNAMIC EVALUATION OF 2 REGIMENS OF MOLSIDOMINE IN PATIENTS WITH CHRONIC CONGESTIVE-HEART-FAILURE

We investigated the extent and duration of the haemodynamic effects of two regimens of molsidomine, i.e. two tablets of a standard regimen c onsisting of 4 mg given 6 h apart and one tablet of 16 mg in sustained -release form once daily in 13 patients with chronic congestive heart failure using a placebo-controlled, randomized, double-blind and cross over protocol over a period of 12 h. Both regimens significantly affec ted systolic, mean and diastolic pulmonary arterial pressure (reductio ns of up to 15%), right atrial pressure (reductions of up to 35%) and total pulmonary resistance (reductions of up to 18%). The lower dose a chieved its maximum action after about 1 h and remained effective for 2 h, whereas the higher dose in sustained-release form showed maximal efficacy at 2h and remained active even at 12 h. In contrast, only min or changes in arterial blood pressure, systemic vascular resistance an d cardiac output were observed on both regimens, almost exclusively at 2 h. Heart rate was not affected by either of the regimens tested. Ne ither regimen led to any untoward adverse effects. Thus, molsidomine i s a potent vasodilating agent which, apart from its effects on preload , also acts on pulmonary arterial and right atrial pressures, leaving systemic circulation largely unaffected on the regimens tested. Admini stered on its own, it is therefore suitable for treatment of congestiv e heart failure.