Acute Heart Failure With Low Cardiac Output: Can We Develop a Short-term Inotropic Agent That Does Not Increase Adverse Events?

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• 作者：Umberto Campia (1)
  Savina Nodari (2)
  Mihai Gheorghiade (1)
  
• 关键词：Acute heart failure ; Low cardiac output ; Inotropic drug ; Lusitropic drug ; Istaroxime ; Digoxin ; Myosin activator ; Omecamtiv mecarbil
• 刊名：Current Heart Failure Reports
• 出版年：2010
• 出版时间：September 2010
• 年：2010
• 卷：7
• 期：3
• 页码：100-109
• 全文大小：330KB
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• 作者单位：Umberto Campia (1)
  Savina Nodari (2)
  Mihai Gheorghiade (1)
  
  1. Center for Cardiovascular Quality and Outcomes, Northwestern University Feinberg School of Medicine, 645 North Michigan Avenue, Suite 1006, Chicago, IL, 60611, USA
  2. Section of Cardiovascular Diseases, Department of Experimental and Applied Medicine, University of Brescia, Brescia, Italy
  

文摘

Acute heart failure represents an increasingly common cause of hospitalization, and may require the use of inotropic drugs in patients with low cardiac output and evidence of organ hypoperfusion. However, currently available therapies may have deleterious effects and increase mortality. An ideal inotropic drug should restore effective tissue perfusion by enhancing myocardial contractility without causing adverse effects. Such a drug is not available yet. New agents with different biological targets are under clinical development. In particular, istaroxime seems to dissociate the inotropic effect exerted by digitalis (inhibition of the membrane sodium/potassium adenosine triphosphatase) from the arrhythmic effect and to ameliorate diastolic dysfunction (via sarcoendoplasmic reticulum calcium adenosine triphosphatase activation). Additionally, the myosin activator omecamtiv mecarbil appears to have promising characteristics, while genetic therapy has been explored in animal studies only. Further investigations are needed to confirm and expand the effectiveness and safety of these agents in patients with acute heart failure and low cardiac output.