Περίληψη:
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. © 2019 The Authors
Συγγραφείς:
Farmakis, D.
Agostoni, P.
Baholli, L.
Bautin, A.
Comin-Colet, J.
Crespo-Leiro, M.G.
Fedele, F.
García-Pinilla, J.M.
Giannakoulas, G.
Grigioni, F.
Gruchała, M.
Gustafsson, F.
Harjola, V.-P.
Hasin, T.
Herpain, A.
Iliodromitis, E.K.
Karason, K.
Kivikko, M.
Liaudet, L.
Ljubas-Maček, J.
Marini, M.
Masip, J.
Mebazaa, A.
Nikolaou, M.
Ostadal, P.
Põder, P.
Pollesello, P.
Polyzogopoulou, E.
Pölzl, G.
Tschope, C.
Varpula, M.
von Lewinski, D.
Vrtovec, B.
Yilmaz, M.B.
Zima, E.
Parissis, J.
Λέξεις-κλειδιά:
alpha 1 adrenergic receptor; cyclic AMP phosphodiesterase; dobutamine; dopamine; dopamine 1 receptor; dopamine 2 receptor; enoximone; epinephrine; levosimendan; milrinone; noradrenalin; beta adrenergic receptor stimulating agent; cardiotonic agent, acute heart failure; Article; artificial ventilation; cardiogenic shock; cardiovascular mortality; dose response; drug half life; extracorporeal oxygenation; heart arrhythmia; heart hemodynamics; heart muscle ischemia; hospital mortality; human; hypotension; pragmatic trial; priority journal; pulmonary hypertension; quality of life; tachycardia; treatment indication; treatment outcome; treatment planning; treatment response; vasodilatation; clinical practice; consensus; heart failure; patient selection, Adrenergic beta-Agonists; Cardiotonic Agents; Consensus; Heart Failure; Humans; Patient Selection; Practice Patterns, Physicians'
