Levosimendan, dobutamine, and milrinone improve haemodynamic status in low-output heart failure patients without any single agent demonstrating consistent superiority over the others.
Do levosimendan, dobutamine, and milrinone improve haemodynamic status in patients with low-output heart failure, and is one agent superior?
Levosimendan, dobutamine, and milrinone all improve haemodynamic status in low-output heart failure, with no single agent showing consistent superiority, supporting individualized selection.
The use of inotropes improves haemodynamic status in patients with low-output HF, with no consistent superiority of one agent over the others. These findings support the current clinical practice of agent selection based on individual patient characteristics. Head-to-head trials in well-phenotyped HF populations are warranted to guide personalised inotrope use.
Nuzzi et al. (2026) studied this question. Levosimendan, dobutamine, and milrinone improve haemodynamic status in low-output heart failure patients without any single agent demonstrating consistent superiority over the others.