EFFECT OF MAINTENANCE MOLSIDOMINE THERAPY ON PORTAL AND CARDIAC HEMODYNAMICS IN PATIENTS WITH LIVER-CIRRHOSIS

The aim of the study was to examine the effects of maintenance molisid omine therapy on portal and cardiac haemodynamics in patients with con firmed alcoholic or nonalcoholic liver cirrhosis and portal hypertenti on. Molsidomine is a selective reducer of preload without development of tolerance. 16 patients with portally decompensated cirrhosis of the liver following an initial or recurrent episode of bleeding form oeso phageal/fundal varices were on long-term treatment (4-24 months) with 2 or 3x8 mg molsidomine/day (Corvaton(R) retard). They were followed u p after 3-6 months. 6 of the 16 had been treated previously with propr anolol for haemorrhage prophylaxis over 11+/-15 months. In a total of 70 treatment months with propranolol, 10 recurrent bleeds had occurred . During 166 treatment months with molsidomine only 4 patients suffere d five recurrences of bleeding. This long-term treatment showed reduct ions in hepatic venous pressure gradient of 24.8% (n=8) (p < 0.05), va riceal pressure of 28,7% (n=7) (p < 0.05) and size of varices of 17% ( n=8). This occured without any clinically relevant impairment of syste mic cardiovascular regulation. Therefore long-term therapy with molsid omine may be suitable for prophylaxis of haemorrhage of oesophageal va rices.