A pragmatic approach to the use of inotropes for the management of acute and advanced heart failure: An expert panel consensus

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:297

Article

Farmakis, Dimitrios^1,2  Agostoni, Piergiuseppe^3,4  Baholli, Loant⁵  Bautin, Andrei⁶  Comin-Colet, Josep⁷  Crespo-Leiro, Maria G.⁸  Fedele, Francesco⁹  Manuel Garcia-Pinilla, Jose¹⁰  Giannakoulas, George¹¹  Grigioni, Francesco¹²  Gruchala, Marcin¹³  Gustafsson, Finn¹⁴  Harjola, Veli-Pekka¹⁵  Hasin, Tal¹⁶  Herpain, Antoine¹⁷  Iliodromitis, Efstathios K.²  Karason, Kristjan¹⁸  Kivikko, Matti^19,20  Liaudet, Lucas^21,22,23  Ljubas-Macek, Jana²⁴  Marini, Marco²⁵  Masip, Josep^26,27  Mebazaa, Alexandre^28,29,30  Nikolaou, Maria³¹  Ostadal, Petr³²  Poder, Pentti³³  Pollesello, Piero²⁰  Polyzogopoulou, Eftihia³⁴  Poelzl, Gerhard³⁵  Tschope, Carsten^36,37  Varpula, Marjut^38,39  von Lewinski, Dirk⁴⁰  Vrtovec, Bojan⁴¹  Yilmaz, Mehmet Birhan⁴²  Zima, Endre⁴³  Parissis, John^2,34 

[1] Univ Cyprus, Sch Med, Nicosia, Cyprus

[2] Univ Athens, Attikon Univ Hosp, Dept Cardiol 2, Athens, Greece

[3] IRCCS, Ctr Cardiol Monzino, Milan, Italy

[4] Univ Milan, Dept Clin Sci & Community Hlth, Cardiovasc Sect, Milan, Italy

[5] Klinikum Dortmund gGmbH, Med Klin Mitte Schwerpunkte Kardiol & Internist I, Dortmund, Germany

[6] Almazov Natl Med Res Ctr, Dept Anesthesiol, St Petersburg, Russia

[7] Univ Barcelona, IDIBELL, Hosp Univ Bellvitge, Heart Dis Inst, Lhospitalet De Llobregat, Spain

[8] Univ A Coruna UDC, Inst Invest Biomed A Coruna INIBIC, Complexo Hosp Univ A Coruna CHUAC CIBERCV, La Coruna, Spain

[9] Univ Roma La Sapienza, Dept Cardiovasc Resp Nephrol Anesthesiol & Geriat, Rome, Italy

[10] Hosp Univ Virgen de la Victoria, Dept Cardiol, Heart Failure & Familial Cardiopathies Unit, Malaga, Spain

[11] Aristotle Univ Thessaloniki, Thessaloniki, Greece

[12] Univ Bologna, S Orsola Malpighi Hosp, Dept Expt Diagnost & Specialty Med, Bologna, Italy

[13] Med Univ Gdansk, Dept Cardiol 1, Gdansk, Poland

[14] Univ Copenhagen, Rigshosp, Dept Cardiol, Copengahen, Denmark

[15] Univ Helsinki, Helsinki Univ Hosp, Emergency Med, Helsinki, Finland

[16] Shaare Zedek Med Ctr, Jesselson Integrated Heart Ctr, Jerusalem, Israel

[17] Univ Libre Bruxelles, Erasme Hosp, Expt Lab Intens Care, Dept Intens Care, Brussels, Belgium

[18] Sahlgrens Univ Hosp, Transplant Inst, Gothenburg, Sweden

[19] Jorvi Hosp, Dept Cardiol S7, Espoo, Finland

[20] Orion Pharma, Crit Care Proprietary Prod, Espoo, Finland

[21] CHU Vaudois, Serv Med Intens Adulte, Lausanne, Switzerland

[22] CHU Vaudois, Ctr Brules, Lausanne, Switzerland

[23] Fac Biol & Med, Lausanne, Switzerland

[24] Univ Zagreb, Univ Hosp Ctr Zagreb, Dept Cardiovasc Dis, Zagreb, Croatia

[25] Osped Riuniti, Dept Cardiovasc Sci, Ancona, Italy

[26] Univ Barcelona, Consorci Sanit Integral, Intens Care Dept, Barcelona, Spain

[27] Hosp Sanitas CIMA, Dept Cardiol, Barcelona, Spain

[28] St Louis Univ Hosp, AP HP, Dept Anaesthesiol & Crit Care Med, Paris, France

[29] Lariboisiere Univ Hosp, Paris, France

[30] INSERM, UMR S 942, Paris, France

[31] Gen Hosp Sismanogleio Amalia Fleming, Dept Cardiol, Melissia, Greece

[32] Na Homolce Hosp, Cardiovasc Ctr, Prague, Czech Republic

[33] North Estonia Med Ctr, Dept Cardiol, Tallinn, Estonia

[34] Univ Athens, Attikon Univ Hosp, Emergency Dept, Athens, Greece

[35] Med Univ, Univ Klin Innere Med 3, Innsbruck, Austria

[36] Charite Univ Med Berlin, Campus Virchow Klinikum CVK, Dept Cardiol, Berlin, Germany

[37] Ctr Regenerat Therapies, Berlin Inst Hlth, BCRT, Berlin, Germany

[38] Univ Helsinki, Heart & Lung Ctr, Dept Cardiol, Helsinki, Finland

[39] Helsinki Univ Hosp, Helsinki, Finland

[40] Med Univ, Dept Cardiol, Myokardiale Energet & Metabolismus Res Unit, Graz, Austria

[41] Univ Ljubljana, Med Ctr, Dept Cardiol, Adv Heart Failure & Transplantat Ctr, Ljubljana, Slovenia

[42] Dokuz Eylul Univ, Fac Med, Dept Cardiol, Izmir, Turkey

[43] Semmelweis Univ, Heart & Vasc Ctr, Budapest, Hungary

关键词: Acute heart failure;    Advanced heart failure;    Inotropes;    Inodilators;    Levosimendan;    Dobutamine;    Milrinone;    Norepinephrine;   

DOI  :  10.1016/j.ijcard.2019.09.005

来源: Elsevier

【 摘 要 】

Inotropes aim at increasing cardiac output by enhancing cardiac contractility. They constitute the third pharmacological pillar in the treatment of patients with decompensated heart failure, the other two being diuretics and vasodilators. Three classes of parenterally administered inotropes are currently indicated for decompensated heart failure, (i) the beta adrenergic agonists, including dopamine and dobutamine and also the catecholamines epinephrine and norepinephrine, (ii) the phosphodiesterase III inhibitor milrinone and (iii) the calcium sensitizer levosimendan. These three families of drugs share some pharmacologic traits, but differ profoundly in many of their pleiotropic effects. Identifying the patients in need of inotropic support and selecting the proper inotrope in each case remain challenging. The present consensus, derived by a panel meeting of experts from 21 countries, aims at addressing this very issue in the setting of both acute and advanced heart failure. (C) 2019 The Authors. Published by Elsevier B.V.

【 授权许可】

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