[Inotropic therapy in heart failure: general aspects and clinical results].
Classic inotropic agents such as beta-adrenergic agonists and phosphodiesterase III inhibitors have beneficial but transitory hemodynamic effects in patients with acute and chronic heart failure. In this context, the available data suggest that long term inotropic therapy has a negative impact on morbidity and mortality in patients with heart failure. For this reason, these agents are mainly used for the treatment of refractory episodes of decompensation and they are also used as a "bridge" (transplant, revascularization, recovery) or as a palliative measure. We present a revision of the general aspects of inotropes including main published clinical trials and some findings of its combined use with beta blockers. Furthermore, we describe a promising and differential therapeutic approach represented by calcium sensitizer agents (levosimendan).
Manito
Nicolás
N
Unidad de Insuficiencia Cardíaca y Trasplante Cardíaco, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. nml@csub.scs.es
Kaplinsky
Edgardo J
EJ
Pujol
Ramón
R
D002316:Cardiotonic Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004280:Dobutamine / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D020105:Milrinone / Q000627:therapeutic use; D016896:Treatment Outcome
D002316:Cardiotonic Agents; D004280:Dobutamine; D020105:Milrinone