[Inotropic agents].

Abstract

We now know pharmacological negative inotropic agent, i. e. beta-blocker, increase cardiac contractility when given chronically to patients with chronic heart failure. In contrast, positive inotropic agents have consistently been shown to increase mortality when given chronically. The routine use of inotropes in either acute or the chronic setting is not supported by the available data. However, some appropriate uses of inotropes are as temporary use of refractory acutely decompensated heart failure, or as a bridge to definitive treatment, or palliative measure in a subset of patients with end-stage heart failure.