慢性心不全患者におけるMolsidomineの血行力学的効果

Effects of Molsidomine on hemodynamics for the patients with chronic heart failure

　ジギタリス剤，利尿剤に次ぐ第3の心不全治療剤として末梢血管拡張療法がとなえられ最近のトピックとなった感がある^1〜3）。

　血管拡張剤には抵抗血管系に働き血管を拡張させるPhentolamine，Phenoxybenzamine，chlorpromazine，hydralazineと抵抗血管系，容量血管系の両方に働くNitroprusside，Prazosineおよび主として容量血管系に働くisosorbide dinitrate，Nitroglycerin等がある。

For the treatment of heart failure, vasodilators, especially nitrites, have been frequently used in recent years, but the short duration of action has been mentioned as a defect of oral nitrites. Molsidomine, as an antianginal drug, is consi-dered to have the same mechanism of action as nitrites, and is said to have a long duration of action. In the present study, effects of Molsidomine on hemodynamics were investigated in patients with heart failure (7 patients with ischemic heart disease and 3 patients with congestive cardiomyopathy) by bedside catheteri-zation. TNG ointment, 25 mg, was used as a control drug. Molsidomine exerts its action most markedly on CVP and PADP, both of which decreased 30% from the pretreatment values. There were little changes in MBP, Cl, PVR and SVR. Molsidomine showed similar effects on these parameters as TNG ointment.