A pragmatic approach to the use of inotropes for the management of acute and advanced heart failure: An expert panel consensus

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Farmakis D., Agostoni P., Baholli L., Bautin A., Comin-Colet J., Crespo-Leiro M. G., ...Daha Fazla

INTERNATIONAL JOURNAL OF CARDIOLOGY, cilt.297, ss.83-90, 2019 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 297
  • Basım Tarihi: 2019
  • Doi Numarası: 10.1016/j.ijcard.2019.09.005
  • Dergi Adı: INTERNATIONAL JOURNAL OF CARDIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.83-90
  • Anahtar Kelimeler: Acute heart failure, Advanced heart failure, Inotropes, Inodilators, Levosimendan, Dobutamine, Milrinone, Norepinephrine, QUALITY-OF-LIFE, INTERMITTENT LEVOSIMENDAN TREATMENT, LONG-TERM, CARDIOGENIC-SHOCK, CLINICAL CHARACTERISTICS, SYSTOLIC FUNCTION, REPETITIVE USE, MILRINONE, INFUSIONS, MORTALITY
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

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 support and selecting the proper inotrope in each case remain challenging. The present consensus, derived by a panel meeting of experts from 21 countries, aims at addressing this very issue in the setting of both acute and advanced heart failure. (C) 2019 The Authors. Published by Elsevier B.V.