[The long-term effect of molsidomine on frequency of hemorrhage, portal and cardiac hemodynamics in patients with liver cirrhosis--a pilot study].
The aim of the study was to examine the effects of maintenance molsidomine therapy on portal and cardiac haemodynamics in patients with confirmed alcoholic or nonalcoholic liver cirrhosis and portal hypertension. Molsidomine is a selective reducer of preload without development of tolerance. 16 patients with portally decompensated cirrhosis of the liver following an initial or recurrent episode of bleeding form oesophageal/fundal varices were on long-term treatment (4-24 months) with 2 or 3 x 8 mg molsidomine/day (Corvaton retard). They were followed up after 3-6 months. 6 of the 16 had been treated previously with propranolol for haemorrhage prophylaxis over 11 +/- 15 months. In a total of 70 treatment months with propranolol, 10 recurrent bleeds had occurred. During 166 treatment months with propranolol, 10 recurrent bleeds had occurrences of bleeding. This long-term treatment showed reductions in hepatic venous pressure gradient of 24.8% (n = 8) (p < 0.05), variceal pressure of 28.7% (n = 7) (p < 0.05) and size of varices of 17% (n = 8). This occurred without any clinically relevant impairment of systemic cardiovascular regulation. Therefore long-term therapy with molsidomine may be suitable for prophylaxis of haemorrhage of oesophageal varices.
Hüppe
D
D
Abteilung für Gastroenterologie und Hepatologie, Berufsgenossenschaftliche Krankenanstalten Bergmannsheil Bochum, Universität-Klinik.
Jäger
D
D
Tromm
A
A
Barmeyer
J
J
May
B
B
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004932:Esophageal and Gastric Varices / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D006975:Hypertension, Portal / Q000188:drug therapy* / Q000503:physiopathology; D008104:Liver Cirrhosis, Alcoholic / Q000188:drug therapy* / Q000503:physiopathology; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012008:Recurrence; D015911:Sclerotherapy
Langzeiteinfluss von Molsidomin auf Blutungshäufigkeit, portale und kardiale Hämodynamik bei Patienten mit Leberzirrhose--eine Pilotstudie.