Current Status of Inotropes in Heart Failure

Heart Fail Clin. 2018 Oct;14(4):601-616. doi: 10.1016/j.hfc.2018.06.010. Epub 2018 Aug 17.

Abstract

Inotropes are medications that improve the contractility of the heart and are used in patients with low cardiac output or evidence of end-organ dysfunction. Since their initial discovery, inotropes have held promise in alleviating symptoms and potentially increasing longevity in such patients. Decades of intensive study have further elucidated the benefits and risks of using inotropes. In this article, the authors discuss the history of inotropes, their indications, mechanism of action, and current guidelines pertaining to their use in heart failure. The authors provide insight into their appropriate use and related shortcomings and the practical aspects of inotrope use.

Keywords: Cardiogenic; Dobutamine; Dopamine; Heart failure; Inotropes; Milrinone; Palliative care; Shock.

Publication types

  • Review

MeSH terms

  • Cardiac Output, Low* / drug therapy
  • Cardiac Output, Low* / etiology
  • Cardiac Output, Low* / physiopathology
  • Cardiotonic Agents / therapeutic use*
  • Heart Failure / complications
  • Heart Failure / drug therapy*
  • Heart Failure / physiopathology
  • Humans
  • Treatment Outcome
  • Ventricular Function / drug effects
  • Ventricular Function / physiology*

Substances

  • Cardiotonic Agents