Inotropes in Advanced Heart Failure: The Last Tool in the Box of Failures?

Haider, Lamis; Mewton, Nathan

This article discusses the use of inotropic agents in the treatment of advanced heart failure. While inotropes have been shown to have immediate hemodynamic effects, studies have consistently shown a lack of significant impact on hard clinical outcomes and even suggested a harmful effect on mortality. As a result, the use of inotropes is left to physicians' discretion with low-level evidence-based medicine. The article provides a review of different inotropic drugs and their use in outpatient advanced heart failure, acute decompensated heart failure, and cardiogenic shock. The authors also highlight the potential of omecamtiv mercabil, a selective myosin activator, in a specific subgroup of patients. The article concludes by emphasizing the need for further research and clinical trials to improve outcomes for advanced heart failure patients.

HEART failure patients; MEDICAL students; HEART failure; CARDIAC contraction; CARDIOGENIC shock; CARDIAC output

Cardiology, 2024, Vol 149, Issue 5, p438

0008-6312

Academic Journal

10.1159/000538994