Effects of molsidomine on regional contraction and global function of the left ventricle

Fifteen consecutive patients (mean age 54 years) with proven coronary heart disease were studied with radionuclide ventriculography. After resting and exercise control studies, repeat studies were performed after administration of 4 mg of molsidomine sublingually and again after administration of 10 mg of metoprolol intravenously. Rest to exercise ejection fraction (EF) decreased significantly. This was significantly attenuated by molsidomine and by metoprolol. In a subset of nine patients with exercise ischemia, EF showed significant (p less than 0.05) improvement after molsidomine administration (46.7 +/- 13.7% to 57.1 +/- 16.7%), which was diminished to 54.4 +/- 10.5% after metoprolol administration. In the subgroup without exercise ischemia, molsidomine increased the EF to a lesser extent (47.3 +/- 12.7% to 52.6 +/- 13.4%, p less than 0.05). After administration of metoprolol the EF decreased below the control level (44.4 +/- 10.6%). Regional Fourier amplitudes accentuated the differences between the two groups. We conclude that molsidomine and metoprolol improve left ventricular function in patients with coronary heart disease and ischemia during exercise. In patients with reduced left ventricular function without signs of ischemia, molsidomine improves function as well and should be used additionally, if beta blockers are indicated for other reasons.