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Cardiotonic agents, also known as cardiac inotropes or stimulants, have a positive impact on the myocardium (muscular layer of the heart) by enhancing its contractility. . Unlike general inotropes, these agents exhibit a higher level of specificity as they selectively target the myocar
The term inotropic state is most commonly used in reference to various drugs that affect the strength of contraction of heart muscle. However, it can also refer to pathological conditions. For example, enlarged heart muscle can increase inotropic state, whereas dead heart muscle can decrease it.
PDE3 inhibitors are indicated as inotropics for the therapy of acute heart failure if catecholamines are ineffective. [2] Well controlled studies have shown that these drugs generally increase mortality , [ 3 ] when used for the therapy of acute heart failure, so they have to be applied under close observation.
The effects of amrinone vary widely with species and experimental condition; therefore, its inotropic effects are variable. [3] A loss in sensitivity to phosphodiesterase 3 inhibitors, including amrinone, has been observed in end stage heart failure in humans; other treatment options may be more useful for improvement in these stages. [3]
Drugs that positively render the effects of catecholamines such as norepinephrine and epinephrine that enhance contractility are considered to have a positive inotropic effect. The ancient herbal remedy digitalis appears to have both inotropic and chronotropic properties that have been recorded encyclopedically for centuries and it remains ...
A mixed phosphodiesterase 3 inhibitor and ion-channel modifier that has modest, dose-dependent, positive inotropic activity, but minimal negative chronotropic activity. Vesnarinone improves ventricular performance most in patients with the worst degree of heart failure .
A cardiac stimulant is a drug which acts as a stimulant of the heart – e.g., via positive chronotropic action (increased heart rate) and/or inotropic action (increased myocardial contractility). They increase cardiac output (the amount of blood pumped by the heart over time).
Levosimendan is a calcium sensitizer — it increases the sensitivity of the heart to calcium, thus increasing cardiac contractility without a rise in intracellular calcium. Levosimendan exerts its positive inotropic effect by increasing calcium sensitivity of myocytes by binding to cardiac troponin C in a calcium
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