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Negative inotropic agents decrease myocardial contractility and are used to decrease cardiac workload in conditions such as angina. While negative inotropism may precipitate or exacerbate heart failure in the short term, certain beta blockers (e.g. carvedilol , bisoprolol and metoprolol ) have been believed to reduce long-term morbidity and ...
The class of CCBs known as dihydropyridines mainly affect arterial vascular smooth muscle and lower blood pressure by causing vasodilation. The phenylalkylamine class of CCBs mainly affect the cells of the heart and have negative inotropic and negative chronotropic effects. The benzothiazepine class of CCBs combine effects of the other two classes.
Negative inotropes improve left ventricular (LV) obstruction by decreasing LV ejection acceleration and hydrodynamic forces on the mitral valve. Disopyramide's particular efficacy is due to its potent negative inotropic effects; in head-to-head comparison, it is more effective for gradient reduction than either beta-blocker or verapamil. [ 16 ]
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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 stimulant inotropes, such as Digoxin, cause higher concentrations of calcium ions which increase contractility. Excess calcium (hypercalcemia) is also a positive inotrope. Drugs that are negative inotropes include beta blockers and calcium channel blockers. Hypoxia, acidosis, hyperkalemia are also negative inotropic agents. [citation needed]
Non-dihydropyridine calcium channel blockers such as verapamil block the slow inward calcium current in cardiac tissues, thereby having a negatively dromotropic, chronotropic and inotropic effect. [5] This (and other) pharmacological effect makes these drugs useful in the treatment of angina pectoris.
Compared with certain other L-type calcium channel blockers (for example those of the phenylalkylamine class such as verapamil) that have significant action at the heart, the dihydropyridine calcium channel blockers lower blood pressure mainly by relaxing the smooth muscle of the blood vessel walls. [3]