Inotropes

Research output: Contribution to journalReview articlepeer-review

79 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)2069-2078
Number of pages10
JournalJournal of the American College of Cardiology
Volume63
Issue number20
DOIs
StatePublished - May 27 2014

Keywords

  • acute heart failure
  • cardiogenic shock
  • inotrope

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