| Old and new intravenous inotropic agents in the treatment of advanced heart failure. | |
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MedLine Citation:
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PMID: 21875509 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Inotropic agents are administered to improve cardiac output and peripheral perfusion in patients with systolic dysfunction and low cardiac output. However, there is evidence of increased mortality and adverse effects associated with current inotropic agents. These adverse outcomes may be ascribed to patient selection, increased myocardial energy expenditure and oxygen consumption, or to specific mechanisms of action. Both sympathomimetic amines and type III phosphodiesterase inhibitors act through an increase in intracellular cyclic adenosine monophoshate and free calcium concentrations, mechanisms that increase oxygen consumption and favor arrhythmias. Concomitant peripheral vasodilation with some agents (phosphodiesterase inhibitors and levosimendan) may also lower coronary perfusion pressure and favor myocardial damage. New agents with different mechanisms of action might have a better benefit to risk ratio and allow an improvement in tissue and end-organ perfusion with less untoward effects. We have summarized the characteristics of the main inotropic agents for heart failure treatment, the data from randomized controlled trials, and future perspectives for this class of drugs. |
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Authors:
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Marco Metra; Luca Bettari; Valentina Carubelli; Livio Dei Cas |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Progress in cardiovascular diseases Volume: 54 ISSN: 1873-1740 ISO Abbreviation: Prog Cardiovasc Dis Publication Date: 2011 Sep-Oct |
Date Detail:
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Created Date: 2011-08-30 Completed Date: 2011-10-24 Revised Date: 2013-05-02 |
Medline Journal Info:
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Nlm Unique ID: 0376442 Medline TA: Prog Cardiovasc Dis Country: United States |
Other Details:
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Languages: eng Pagination: 97-106 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
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Cardiology, Department of Experimental and Applied Medicine, University of Brescia, Civil Hospital of Brescia, Italy. metramarco@libero.it |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cardiac Output
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drug effects Cardiotonic Agents / administration & dosage*, adverse effects Disease Progression Evidence-Based Medicine Heart Failure / drug therapy*, physiopathology Humans Infusions, Intravenous Risk Assessment Risk Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Cardiotonic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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