Adverse Hemodynamic and Clinical Responses to Long-term Inotropic Therapy in Patients with Severe Chronic Congestive Heart Failure

Abstract

There has been an enormous interest during the last decade in the development of positive inotropic drugs for the long-term treatment of patients with severe congestive heart failure [1]. Such agents have a particular appeal, since the primary defect in patients with heart failure is thought to be a depressed inotropic state. Some investigators have suggested, however, that the decrease in contractility seen in patients with congestive heart failure is a beneficial compensatory mechanism that permits the prolonged survival of the myocardial cell under increased loading conditions [2,3]. Hence, attempts to stimulate the failing heart pharmacologically may produce long-term detrimental effects in these patients.