A pragmatic approach to the use of inotropes for the management of acute and advanced heart failure: An expert panel consensus.
- Farmakis, Dimitrios
- Agostoni, Piergiuseppe
- Baholli, Loant
- Bautin, Andrei
- Comin-Colet, Josep
- Crespo-Leiro, Maria G
- Fedele, Francesco
- García-Pinilla, Jose Manuel
- Giannakoulas, George
- Grigioni, Francesco
- Gruchała, Marcin
- Gustafsson, Finn
- Harjola, Veli-Pekka
- Hasin, Tal
- Herpain, Antoine
- Iliodromitis, Efstathios K
- Karason, Kristjan
- Kivikko, Matti
- Liaudet, Lucas
- Ljubas-Maček, Jana
- Marini, Marco
- Masip, Josep
- Mebazaa, Alexandre
- Nikolaou, Maria
- Ostadal, Petr
- Põder, Pentti
- Pollesello, Piero
- Polyzogopoulou, Eftihia
- Pölzl, Gerhard
- Tschope, Carsten
- Varpula, Marjut
- von Lewinski, Dirk
- Vrtovec, Bojan
- Yilmaz, Mehmet Birhan
- Zima, Endre
- Parissis, John
DOIAbstract
Inotropes aim at increasing cardiac output by enhancing cardiac contractility. They constitute the third pharmacological pillar in the treatment of patients with decompensated heart failure, the other two being diuretics and vasodilators. Three classes of parenterally administered inotropes are currently indicated for decompensated heart failure, (i) the beta adrenergic agonists, including dopamine and dobutamine and also the catecholamines epinephrine and norepinephrine, (ii) the phosphodiesterase III inhibitor milrinone and (iii) the calcium sensitizer levosimendan. These three families of drugs share some pharmacologic traits, but differ profoundly in many of their pleiotropic effects. Identifying the patients in need of inotropic suppor...
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