title: Inotropes.
abstract: Inotropes have been fundamental to resuscitation of acute cardiogenic shock for decades. Heart failure and cardiogenic shock, in severe cases, are syndromes characterized in many patients by a reduction in myocardial contractile force. While inotropes successfully increase cardiac output, their use has been plagued by excessive mortality due to increased tachycardia and myocardial oxygen consumption leading to arrhythmia and myocardial ischemia. There is a pressing need for new inotropic agents that avoid these harmful effects. This review describes the mechanism of action and the clinical utility of some of the older inotropic agents, which are still commonly used, and provides an update for physicians on the development of newer inotropic drugs. The field is rapidly changing, and it is likely that new agents will be designed that improve systolic performance without necessarily increasing the myocardial oxygen consumption.
authors: Department of Medicine, Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota. Electronic address: franc354@umn.edu.
authors: Gary S
authors: GS
authors: Francis
authors: Department of Medicine, Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota.
authors: Jason A
authors: JA
authors: Bartos
authors: Department of Medicine, Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota.
authors: Sirtaz
authors: S
authors: Adatya
mesh_terms: D002316:Cardiotonic Agents / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D009200:Myocardial Contraction / Q000187:drug effects*; D012770:Shock, Cardiogenic / Q000188:drug therapy* / Q000503:physiopathology; D013599:Systole / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents
keywords: acute heart failure; cardiogenic shock; inotrope