Effects of molsidomine, a long acting venous dilator, on portal hypertension. A hemodynamic study in patients with cirrhosis.

Abstract

The present study investigated the effects of molsidomine, a predominant venous dilator which, contrary to organic nitrates, does not produce pharmacological tolerance on splanchnic and systemic hemodynamics in patients with cirrhosis. Twenty-seven cirrhotic portal hypertensive patients were studied prior to and up to 2 h after the oral administration of 2 mg of molsidomine (n = 11), 4 mg of molsidomine (n = 8) or placebo (n = 8). Molsidomine caused a significant reduction in the hepatic venous pressure gradient. The mean decrease at 60 min was -6.8 +/- 9% after 2 mg (p less than 0.05) and -15.4 +/- 12% after 4 mg (p less than 0.01). The decrease in the hepatic venous pressure gradient was maintained at 120 min: -11% after 2 mg (p less than 0.05) and -19% with 4 mg (p less than 0.01). This was associated with mild changes in azygos blood flow and with a significant decrease in hepatic blood flow (-17%, p less than 0.05). There was a moderate reduction in mean arterial pressure (-12.6% after 2 mg and -13.2% after 4 mg, p less than 0.01), which was due to a reduction in cardiac output, without any significant fall in systemic vascular resistance. Placebo administration did not change systemic or hepatic hemodynamics. This study shows that molsidomine causes a significant and sustained reduction in portal pressure in patients with cirrhosis, suggesting the potential role of this agent in the treatment of portal hypertension.

• Authors: L Ruiz del Arbol, J C García-Pagán, F Feu, M P Pizcueta, J Bosch, J Rodés
• Journal: Journal of hepatology (J Hepatol) Vol. 13 Issue 2 Pg. 179-86 (Sep 1991) ISSN: 0168-8278 [Print] Netherlands
• PMID: 1744422 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Delayed-Action Preparations
• Molsidomine

Topics

• Adult
• Aged
• Delayed-Action Preparations
• Dose-Response Relationship, Drug
• Female
• Hemodynamics (drug effects)
• Hepatic Veins (drug effects)
• Humans
• Hypertension, Portal (drug therapy, etiology, physiopathology)
• Liver Cirrhosis (complications)
• Male
• Middle Aged
• Molsidomine (pharmacology, therapeutic use)
• Splanchnic Circulation (drug effects)