INTRAVENOUS MOLSIDOMINE IN HEART-FAILURE PART III - LACK OF CLINICALLY RELEVANT TOLERANCE WITH MOLSIDOMINE

In 7 patients (2 women, 5 men, median age 65 years) with chronic heart failure (NYHA II-III) the long-term effect of intravenous molsidomine was investigated, Bolus application of 5 mg molsidomine i.v. led to a significant reduction of mean pulmonary capillary wedge pressure (PCm ) from 29 to 19 mmHg, of mean pulmonary artery pressure (PAm) from 39 to 26 mmHg, and of mean right atrial pressure (RAm) from 8 to 6 mmHg ( medians, p < 0.05 each, hour 1), After disappearance of the primary ef fect (hour 5) i.v. molsidomine (4 to 10 mg/h) was given continuously f or 60 hours, Again, significant changes were documented (hour 10) of P Cm from 24 to 16 mmHg, of PAm from 33 to 27 mmHg and of RAm from 9 to 5 mmHg (p < 0.05 each), In contrast, no statistically significant chan ges for the measurements taken between 10 and 60 hours could be found for PCm, PAm and RAm (p > 0.30), At hour 60 the value for PCm was 17 m mHg, for PAm 26 mmHg and for RAm 3 mmHg, Conclusions: Continuous i.v. infusion of molsidomine leads to a significant decrease of PCm, PAm an d RAm over a time period of up to 60 hours without leading to hemodyna mically relevant tolerance, Thus, molsidomine should be considered, wh en long-term i.v. application of NO donors is needed.