Agents with inotropic properties for the management of acute heart failure syndromes. Traditional agents and beyond

John R. Teerlink, Marco Metra*, Valerio Zacà, Hani N. Sabbah, Gadi Cotter, Mihai Gheorghiade, Livio Dei Cas

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

69 Scopus citations

Abstract

Treatment with inotropic agents is one of the most controversial topics in heart failure. Initial enthusiasm, based on strong pathophysiological rationale and apparent empirical efficacy, has been progressively limited by results of controlled trials and registries showing poorer outcomes of the patients on inotropic therapy. The use of these agents remains, however, potentially indicated in a significant proportion of patients with low cardiac output, peripheral hypoperfusion and end-organ dysfunction caused by heart failure. Limitations of inotropic therapy seem to be mainly related to their mechanisms of action entailing arrhythmogenesis, peripheral vasodilation, myocardial ischemia and damage, and possibly due to their use in patients without a clear indication, rather than to the general principle of inotropic therapy itself. This review will discuss the characteristics of the patients with a potential indication for inotropic therapy, the main data from registries and controlled trials, the mechanism of the untoward effects of these agents on outcomes and, lastly, perspectives with new agents with novel mechanisms of action.

Original languageEnglish (US)
Pages (from-to)243-253
Number of pages11
JournalHeart Failure Reviews
Volume14
Issue number4
DOIs
StatePublished - Dec 2009

Keywords

  • Acute heart failure
  • Advanced chronic heart failure
  • Inotropic agents
  • Istaroxime
  • Omecamtiv mecarbil References :
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Agents with inotropic properties for the management of acute heart failure syndromes. Traditional agents and beyond'. Together they form a unique fingerprint.

Cite this