Hemodynamic changes produced by molsidomine in patients with congestive myocardiopathy

The hemodynamic effects of a new drug: molsidomine (M) were evaluated in 9 patients with congestive myocardiopathy. To that end, with a 4-channel Swan-Ganz catheter and cardiac output computer, the following hemodynamic parameters were measured in the control condition (CC) and 5, 15 and 30 minutes after sublingual administration of 4 mg of M: heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), cardiac index (CI), stroke volume index (SVI), systemic vascular resistance (SVR), pulmonary vascular resistance (PVR) and the stroke work index (SWI). Comparing the data in CC and at the end of the study, we found a decrease of 80 +/- 5 to 76 +/- 5 b/m (p less than 0.01) in HR, of 91 +/- 4 to 84 +/- 4 mmHg (p less than 0.01) in MAP and of 3087 +/- 151 to 2758 +/- 131 d/c/s-5 in SVR (p less than 0.02); a drop in PWP of 27 +/- 3 to 20 +/- 3 mmHg (p less than 0.001) and in PVR of 1367 +/- 293 to 1115 +/- 256 d/c/s-5 (p less than 0.001); an increase in SVI of 31 +/- 3 to 34 +/- 2 ml/b/m2 (p less than 0.05) and non-significant changes in CI of 2380 +/- 96 to 2459 +/- 82 ml/m2 (p less than 0.03) and in the SWI of 34 +/- 4 to 37 +/- 4 gm/m2 (p less than 0.1). We conclude that in patients with severe heart failure, the fundamental effects of M appears to be vasodilation in both pulmonary and systemic circulations demonstrated by a fall in PWP, PVR, MAP and SVR together with a mild increase in SVI without significant changes in CI and SWI.