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European Heart Journal 1987 8(8):870-877;
Copyright © 1987 by the European Society of Cardiology.
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© 1987 The European Society of Cardiology

Acute and chronic effects of molsidomine on pulmonary artery pressure and work capacity in patients with coronary heart disease

W. JANSEN*,, T. EGGELING{dagger}, L. MEYER*, M. TAUCHERT* and H. H. HILGER{dagger}

* Medizinische Klinik I, Städtisches Krankenhaus Leverkusen
{dagger} Medizinische Universitätsklinik III. Köln, F.R.G.

Received 5 January 1987; revised 27 May 1986; .

Dr W. Jansen, Medizinische Klinik I, Städtisches Krankenhaus Leverkusen. Dhünnberg 60, D-5090 Leverkusen I, F.R.G.

To test the clinically supposed development of tolerance during chronic molsidomine therapy we studied a total of 11 patients with angiographically-proven coronary heart disease at rest and during ergometric exercise (supine position; submaximal, i.e. 50 W for 3 min, and maximal exercise). pulmonary arterial pressure (PAPmean, floating catheter), arterial blood pressure (RR, cuff method). work capacity (W x min) and duration of exercise loading (sec) were measured at rest and on exercise before and during chronic (4 weeks) oral therapy with 3 x 4mg day-1 of molsidomine. Acute administration of 4 mg molsidomine reduced the mean arterial resting pressure by 12% and under submaximal exercise loading by 8%. After molsidomine, the PAPmean was reduced by 35% at rest; following a period of treatment of 4 weeks no significant decrease in efficacy could be discerned (PAPmean reduction by 31%). Under submaximal and maximal exercise the PAPmean dropped by 44% and 37%. respectively (35.5±6.7 cf. 19.9±4.5 mm Hg: 39.2±6.5 cf. 24.8±7.0 mm Hg). whilst simultaneously the work capacity increased by 93% (281±108 cf. 545±254 W x min). After 4 weeks treatment with 12 mg day-1 of molsidomine, the PAPmean of 22.4±6.6 mm Hg and 30.1±9.9 mm Hg under identical exercise loading conditions. remained significanty below the exercise load value prior to the onset of the medication. The molsidomine-induced increase in the exercise tolerance was maintained throughout the long-term medication (537±268 W x min). With a four week treatment with daily doses of molsidomine there was a persistent effect on the pulmonary arterial pressure and the work capacity. Thus development of tolerance during high dose, long-term molsidomine therapy is not to be expected.

Key Words: Molsidomine, • haemodynamic parameters, • exercise tolerance.


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