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Inotropes and Heart : When to Use and When Not to Use 523

CONCLUSION
End-stage heart failure is a progressive disease with
high mortality and limited medical therapeutic op-
tions. Long-term use of conventional inotropic agents
has been associated with no improvement or even
increased overall mortality. One would hope that the
next generation of inotropic agents will achieve en-
hanced myocardial performance without altering
the velocity of shortening or promoting excessive
calcium modulation. A better understanding of the
physiology and important adverse effects of these
medications should lead to directed clinical use, with
realistic therapeutic goals.
REFERENCES:
1. Inotropes: Journal of the American College of Cardiology Vol. 63, No.
20, 2014
2. Braunwald’ s Heart diseases: text book of cardiovascular medicine- 10th
edition
3. Inotropes and Vasopressors: Review of Physiology and Clinical Use in Car-
diovascular Disease Christopher B. Overgaard, MD; Vladimír Dzˇavík, MD
4. Use of vasopressors and inotropes: UPTODATE 2016
5. Allen LA, Stevenson LW, Grady KL, et al. Decision making in advanced
heart failure: a scientific statement from the American Heart Association.
Circulation 2012;125:1928–52.
6. 2013 ACCF/AHA Guideline for the Management of Heart Failure-A Re-
port of the American College of Cardiology Foundation/American Heart
Association

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