Hemodynamic effects of molsidomine in patients with acute myocardial infarction.

The hemodynamic effects of molsidomine were studied in 48 patients with acute myocardial infarction and compared with hemodynamic properties in a control group of 24 patients. The most pronounced decrease in pulmonary artery diastolic pressure occurs between 30 and 60 minutes after oral administration of 8 to 12 mg (n = 16). There is no major difference in action between the oral and intravenous application of 8 to 12 mg (n = 22). Its effect lasts about 3 to 4 hours and may exceed up to 8 hours in patients with left heart failure (n = 10). The mean arterial pressure is affected only with high doses (12 mg). Cardiac output decreases slightly only in patients without left heart failure. An additional intraindividual comparison of nitroglycerin (1.6 mg sublingually) and molsidomine (12 mg intravenously) (n = 11) revealed no significant difference in hemodynamic effectiveness. Molsidomine, like nitroglycerin, acts primarily to reduce cardiac preload. An additional moderate action on afterload with a slight decline in arterial pressure may be noticed at high doses.