Document Detail


Old and new intravenous inotropic agents in the treatment of advanced heart failure.
MedLine Citation:
PMID:  21875509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Marco Metra; Luca Bettari; Valentina Carubelli; Livio Dei Cas
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Progress in cardiovascular diseases     Volume:  54     ISSN:  1873-1740     ISO Abbreviation:  Prog Cardiovasc Dis     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-08-30     Completed Date:  2011-10-24     Revised Date:  2013-05-02    
Medline Journal Info:
Nlm Unique ID:  0376442     Medline TA:  Prog Cardiovasc Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  97-106     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Cardiology, Department of Experimental and Applied Medicine, University of Brescia, Civil Hospital of Brescia, Italy. metramarco@libero.it
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MeSH Terms
Descriptor/Qualifier:
Cardiac Output / 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:
0/Cardiotonic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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