Long-term clinical and hemodynamic results of molsidomine treatment in patients with refractory heart failure.

In this report we describe the clinical and hemodynamic response of refractory cardiac failure to molsidomine. In the first part of the study the hemodynamic effects of a single oral dose of 2 or 4 mg of molsidomine were compared with placebo control in 23 patients. In the second phase the dose 8 to 24 mg/24 hours was used in nine patients with functional class III or IV symptoms over an average period of 28 months (range 7 to 42 months); a hemodynamic control study was performed. These data demonstrate that molsidomine has a hemodynamic effect on pulmonary artery pressure for 5 to 6 hours, that the peak effect is reached between 1 and 1 1/2 hours after oral intake, and that the clinical and hemodynamic benefits of molsidomine may be maintained in the long term in patients with particularly severe cardiac failure. The conditions of seven patients were clinically improved with treatment; significant reductions in mean right atrial, pulmonary artery, and pulmonary capillary pressures were observed.