Inotropes successfully increase cardiac output in acute cardiogenic shock and heart failure, but their use is limited by excessive mortality due to arrhythmia and myocardial ischemia.
This review highlights the need for novel inotropic agents that can improve cardiac output in heart failure and cardiogenic shock without the adverse effects of increased myocardial oxygen consumption and arrhythmias seen with older agents.
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.
Francis et al. (Wed,) conducted a review in Acute cardiogenic shock and heart failure. Inotropes was evaluated. Inotropes successfully increase cardiac output in acute cardiogenic shock and heart failure, but their use is limited by excessive mortality due to arrhythmia and myocardial ischemia.
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