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Cardiotonic agent

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474: 3310: 877:, act to restore the heart’s pumping function. To prevent further harm to the organs, cardiotonic agents are typically administered alongside oxygen, ventilatory support, and mechanical circulatory support (MCS). As hypoperfusion and organ dysfunction improve, it is recommended to gradually reduce the administration of these agents. However, certain patients who are unable to discontinue cardiotonic agents without experiencing recurrent heart failure symptoms, known as inotropic-dependent patients, may require prolonged usage. This serves as a bridge towards more invasive management approaches, such as 258: 649: 85: 814: 4295:
John G; de Boer, Rudolf A; Dietl, Alexander; Fischmeister, Rodolphe; Harjola, Veli-Pekka; Heymans, Stephane; Hilfiker-Kleiner, Denise; Holzmeister, Johannes; de Keulenaer, Gilles; Limongelli, Giuseppe; Linke, Wolfgang A; Lund, Lars H; Masip, Josep; Metra, Marco; Mueller, Christian; Pieske, Burkert; Ponikowski, Piotr; Ristić, Arsen; Ruschitzka, Frank; Seferović, Petar M; Skouri, Hadi; Zimmermann, Wolfram H; Mebazaa, Alexandre (2019-11-21).
810:, and low blood pressure, placing them at risk of inadequate organ perfusion. While these agents assist in promoting perfusion, their potential for increased mortality and adverse side effects necessitates cautious administration at initially low doses, with careful adjustments under close monitoring. Given the diverse presentations of heart failure and individual patient characteristics, cardiotonic medication uses and preferences vary. 129:, which explains muscle contraction. With increased Ca2+ levels, interactions between Ca2+ and TnC intensify, leading to stronger contractions of the myocardiocytes. Therapeutic doses of cardiac glycosides have been shown to enhance cardiac contractility, benefiting patients with impaired cardiac function, such as those with 4801:"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC" 4696:"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC" 4027:"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC" 4294:
Maack, Christoph; Eschenhagen, Thomas; Hamdani, Nazha; Heinzel, Frank R; Lyon, Alexander R; Manstein, Dietmar J; Metzger, Joseph; Papp, Zoltán; Tocchetti, Carlo G; Yilmaz, M Birhan; Anker, Stefan D; Balligand, Jean-Luc; Bauersachs, Johann; Brutsaert, Dirk; Carrier, Lucie; Chlopicki, Stefan; Cleland,
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Bavendiek, Udo; Berliner, Dominik; Dávila, Lukas Aguirre; Schwab, Johannes; Maier, Lars; Philipp, Sebastian A.; Rieth, Andreas; Westenfeld, Ralf; Piorkowski, Christopher; Weber, Kristina; Hänselmann, Anja; Oldhafer, Maximiliane; Schallhorn, Sven; von der Leyen, Heiko; Schröder, Christoph (May 2019).
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Calcium is a vital element for regulating the contraction and relaxation of the heart muscle. Calcium sensitizers are medications that increase the responsiveness of heart muscle cells to calcium, enabling more forceful contractions while conserving energy. Contraction of the heart muscle relies on
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Authors/Task Force Members; McDonagh, Theresa A.; Metra, Marco; Adamo, Marianna; Gardner, Roy S.; Baumbach, Andreas; Böhm, Michael; Burri, Haran; Butler, Javed; Čelutkienė, Jelena; Chioncel, Ovidiu; Cleland, John G.F.; Coats, Andrew J.S.; Crespo-Leiro, Maria G.; Farmakis, Dimitrios (January 2022).
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Authors/Task Force Members; McDonagh, Theresa A.; Metra, Marco; Adamo, Marianna; Gardner, Roy S.; Baumbach, Andreas; Böhm, Michael; Burri, Haran; Butler, Javed; Čelutkienė, Jelena; Chioncel, Ovidiu; Cleland, John G.F.; Coats, Andrew J.S.; Crespo-Leiro, Maria G.; Farmakis, Dimitrios (January 2022).
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Authors/Task Force Members; McDonagh, Theresa A.; Metra, Marco; Adamo, Marianna; Gardner, Roy S.; Baumbach, Andreas; Böhm, Michael; Burri, Haran; Butler, Javed; Čelutkienė, Jelena; Chioncel, Ovidiu; Cleland, John G.F.; Coats, Andrew J.S.; Crespo-Leiro, Maria G.; Farmakis, Dimitrios (January 2022).
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is specifically recommended as a second-line option for patients with an abnormal left ventricular ejection fraction (≤40%). Digoxin helps alleviate symptoms and reduce hospitalizations related to heart failure, but it does not offer any mortality-reducing benefits. Digoxin may be considered in
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Nystoriak, Matthew A.; Nieves-Cintrón, Madeline; Patriarchi, Tommaso; Buonarati, Olivia R.; Prada, Maria Paz; Morotti, Stefano; Grandi, Eleonora; Fernandes, Julia Dos Santos; Forbush, Katherine; Hofmann, Franz; Sasse, Kent C.; Scott, John D.; Ward, Sean M.; Hell, Johannes W.; Navedo, Manuel F.
925:(the upper chambers of the heart). This abnormal electrical activity causes the atria to contract erratically, resulting in an irregular heartbeat. Treatment primarily focuses on restoring normal heart rhythm and controlling the heart rate to minimise the risk of complications, including 4611:
Gustafsson, Finn; Damman, Kevin; Nalbantgil, Sanem; Van Laake, Linda W.; Tops, Laurens F.; Thum, Thomas; Adamopoulos, Stamatis; Bonios, Michael; Coats, Andrew JS; Crespo-Leiro, Maria G.; Mehra, Mandeep R.; Filippatos, Gerasimos; Hill, Loreena; Metra, Marco; Jankowska, Ewa (April 2023).
929:. According to the ACC/AHA guidelines, intravenous digoxin (cardiac glycoside) can be used in atrial fibrillation (Afib) to assist heartbeats. In multicenter randomised controlled trials, intravenous digoxin was shown to be effective in controlling the heart rate compared to a placebo. 4905:
Joglar, José A.; Chung, Mina K.; Armbruster, Anastasia L.; Benjamin, Emelia J.; Chyou, Janice Y.; Cronin, Edmond M.; Deswal, Anita; Eckhardt, Lee L.; Goldberger, Zachary D.; Gopinathannair, Rakesh; Gorenek, Bulent; Hess, Paul L.; Hlatky, Mark; Hogan, Gail; Ibeh, Chinwe (2024-01-02).
522:, which are small cell fragments involved in blood clotting. Increased levels of cAMP in platelets prevent their activation and reduce their ability to form blood clots. By inhibiting platelet aggregation, PDE3 inhibitors contribute to maintaining healthy and smooth blood flow. 668:, thereby enhancing the sensitivity of heart muscle cells to naturally occurring calcium ions. This heightened sensitivity fosters a more efficient interaction between calcium and the contractile apparatus of the heart muscle. Consequently, calcium can more effectively bind to 30:(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 myocardium. They can be categorised into four distinct groups based on their unique mechanisms of action: 277:
can be collectively regarded as beta-agonists. Specifically, dobutamine selectively binds to β1 receptors located on the surface of specialised cardiac muscle cells. Relative to β2 receptors, β1 is the predominant type in terms of quantity and function within the heart.
111:(the cell’s energy currency), this protein facilitates the transport of extracellular potassium ions (K+) into the cell while exporting sodium ions (Na+) out, maintaining a balanced 1:1 exchange. Thus, when this protein is blocked, Na+ accumulates within cardiomyocytes. 1659:
Navarro, Gemma; Cordomí, Arnau; Brugarolas, Marc; Moreno, Estefanía; Aguinaga, David; Pérez-Benito, Laura; Ferre, Sergi; Cortés, Antoni; Casadó, Vicent; Mallol, Josefa; Canela, Enric I.; Lluís, Carme; Pardo, Leonardo; McCormick, Peter J.; Franco, Rafael (2018-02-28).
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Nagao, Kazuya; Kato, Takao; Yaku, Hidenori; Morimoto, Takeshi; Inuzuka, Yasutaka; Tamaki, Yodo; Yamamoto, Erika; Yoshikawa, Yusuke; Kitai, Takeshi; Taniguchi, Ryoji; Iguchi, Moritake; Kato, Masashi; Takahashi, Mamoru; Jinnai, Toshikazu; Ikeda, Tomoyuki (2022-01-01).
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Dieleman, Joseph L.; Cao, Jackie; Chapin, Abby; Chen, Carina; Li, Zhiyin; Liu, Angela; Horst, Cody; Kaldjian, Alexander; Matyasz, Taylor; Scott, Kirstin Woody; Bui, Anthony L.; Campbell, Madeline; Duber, Herbert C.; Dunn, Abe C.; Flaxman, Abraham D. (2020-03-03).
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Verzicco, Ignazio; Regolisti, Giuseppe; Quaini, Federico; Bocchi, Pietro; Brusasco, Irene; Ferrari, Massimiliano; Passeri, Giovanni; Cannone, Valentina; Coghi, Pietro; Fiaccadori, Enrico; Vignali, Alessandro; Volpi, Riccardo; Cabassi, Aderville (2020-05-19).
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PDE3 inhibitors also have an impact on the smooth muscles found in our blood vessels. By increasing cAMP levels, these medications cause the smooth muscles to relax. This relaxation has a significant benefit in our blood vessels as it leads to
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Leivaditis, Vasileios; Grapatsas, Konstantinos; Papaporfyriou, Anastasia; Galanis, Michail; Koletsis, Efstratios; Charokopos, Nikolaos; Haussmann, Erich; Kaplunov, Vladislav; Papatriantafyllou, Athanasios; Dahm, Manfred (August 2023).
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Navarro, Gemma; Cordomí, Arnau; Casadó-Anguera, Verónica; Moreno, Estefanía; Cai, Ning-Sheng; Cortés, Antoni; Canela, Enric I.; Dessauer, Carmen W.; Casadó, Vicent; Pardo, Leonardo; Lluís, Carme; Ferré, Sergi (2018-03-28).
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Ahmad, Tariq; Miller, P. Elliott; McCullough, Megan; Desai, Nihar R.; Riello, Ralph; Psotka, Mitchell; Böhm, Michael; Allen, Larry A.; Teerlink, John R.; Rosano, Giuseppe M. C.; Lindenfeld, Joann (September 2019).
4908:"2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines" 833:. Whereas in clinically stable patients with sufficient perfusion, cardiac inotrope use is advised against. This caution is due to the heightened risk of adverse cardiovascular outcomes, including 802:
Cardiotonic agents are typically employed as short-term and non-routine therapies for heart failure patients. They are specifically reserved for those with contractile dysfunction in the
50:, possess overlapping classifications due to their ability to engage multiple mechanisms of action. Their inotropic properties make cardiactonic agents critical in addressing inadequate 4239:"Current use of inotropes according to initial blood pressure and peripheral perfusion in the treatment of congestive heart failure: findings from a multicentre observational study" 3603:
Masarone, Daniele; Kittleson, Michelle M.; Pollesello, Piero; Marini, Marco; Iacoviello, Massimo; Oliva, Fabrizio; Caiazzo, Angelo; Petraio, Andrea; Pacileo, Giuseppe (2022-10-29).
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Lim, S. P. R.; Batta, K.; Tan, B. B. (2003). "Calciphylaxis in a patient with alcoholic liver disease in the absence of renal failure: Calciphylaxis in alcoholic liver disease".
1198:"Rationale and design of the DIGIT-HF trial (DIGitoxin to Improve ouTcomes in patients with advanced chronic Heart Failure): a randomized, double-blind, placebo-controlled study" 841:, with hypotension and low blood flow (hypoperfusion), placing the patient at risk of multiorgan failure. In cardiogenic shock management, cardiotonic agents serve 2 functions. 507:. PKA acts as a switch, triggering a cascade of events that enhance the strength and efficiency of the heart's contractions. This ultimately leads to improved cardiac function. 5023:"Global, regional, and national prevalence, incidence, mortality, and risk factors for atrial fibrillation, 1990-2017: results from the Global Burden of Disease Study 2017" 3011:
Li, Monica X.; Gelozia, Shorena; Danmaliki, Gaddafi I.; Wen, Yurong; Liu, Philip B.; Lemieux, M. Joanne; West, Frederick G.; Sykes, Brian D.; Hwang, Peter M. (2018-11-01).
118:. The accumulation of Na+ prompts its efflux from the cell, whilst concurrently allowing Ca2+ influx through this exchanger. Consequently, intracellular Ca2+ levels rise. 4614:"Inotropic therapy in patients with advanced heart failure. A clinical consensus statement from the Heart Failure Association of the European Society of Cardiology" 1425:"Cardiac arrhythmias, electrolyte abnormalities and serum cardiac glycoside concentrations in yellow oleander (Cascabela thevetia) poisoning - a prospective study" 5021:
Dai, Haijiang; Zhang, Quanyu; Much, Arsalan Abu; Maor, Elad; Segev, Amit; Beinart, Roy; Adawi, Salim; Lu, Yao; Bragazzi, Nicola Luigi; Wu, Jianhong (2021-10-28).
3255:"Effects of the calcium sensitizer OR-1896, a metabolite of levosimendan, on post-infarct heart failure and cardiac remodelling in diabetic Goto–Kakizaki rats" 2380: 679:, resulting in stronger contractions without excessive calcium accumulation. By reducing strain on the heart, this mechanism helps minimise the oxygen demand. 4669: 3396:"The Perioperative Use of Levosimendan as a Means of Optimizing the Surgical Outcome in Patients with Severe Heart Insufficiency Undergoing Cardiac Surgery" 4433:
Shankar, Aditi; Gurumurthy, Gayathri; Sridharan, Lakshmi; Gupta, Divya; Nicholson, William J; Jaber, Wissam A; Vallabhajosyula, Saraschandra (2022-02-07).
2656:"PDE3 inhibition with enoximone as first-line therapy for severe persistent pulmonary hypertension of the newborn during neonatal transport: a case report" 2270: 515:, which means the blood vessels widen. Vasodilation helps to reduce resistance against blood flow, allowing for better circulation throughout the body. 3453:
Beiras-Fernandez, Andres; Kornberger, Angela; Oberhoffer, Martin; Kur, Felix; Weis, Marion; Vahl, Christian-Friedrich; Weis, Florian (August 2019).
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Laghlam, Driss; Benghanem, Sarah; Ortuno, Sofia; Bouabdallaoui, Nadia; Manzo-Silberman, Stephane; Hamzaoui, Olfa; Aissaoui, Nadia (2024-03-30).
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Li, Xiaozhao; Ao, Xiang; Liu, Qiong; Yang, Jinghua; Peng, Weisheng; Tang, Rong; Zhong, Yong; Meng, Ting; Gan, Lu; Zhou, Qiaoling (2014-12-01).
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Manolopoulos, Philip Panagiotis; Boutsikos, Ioannis; Boutsikos, Panagiotis; Iacovidou, Nicoletta; Ekmektzoglou, Konstantinos (2020-04-10).
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Rossi, Daniela; Pierantozzi, Enrico; Amadsun, David Osamwonuyi; Buonocore, Sara; Rubino, Egidio Maria; Sorrentino, Vincenzo (April 2022).
3311:"Early Utilization of Mechanical Circulatory Support in Acute Myocardial Infarction Complicated by Cardiogenic Shock | HeartRecovery.com" 2498:"Thrombin regulates intracellular cyclic AMP concentration in human platelets through phosphorylation/activation of phosphodiesterase 3A" 1845:"Ser1928 phosphorylation by PKA stimulates the L-type Ca2+ channel CaV1.2 and vasoconstriction during acute hyperglycemia and diabetes" 5089: 889: 892:, which quantifies the volume of blood expelled from the heart's lower chambers (ventricles) with each contraction. According to the 3253:
Louhelainen, Marjut; Merasto, Saara; Finckenberg, Piet; Vahtola, Erik; Kaheinen, Petri; Levijoki, Jouko; Mervaala, Eero (May 2010).
2329: 1521:"Intermittent low‑dose digoxin may be effective and safe in patients with chronic heart failure undergoing maintenance hemodialysis" 1494: 4881: 1902:"Phosphorylation of skeletal muscle calsequestrin enhances its Ca2+ binding capacity and promotes its association with junctin" 1662:"Cross-communication between Gi and Gs in a G-protein-coupled receptor heterotetramer guided by a receptor C-terminal domain" 893: 497: 489: 297: 3334:
Tsapenko, Mykola V; Tsapenko, Arseniy V; Comfere, Thomas BO; Mour, Girish K; Mankad, Sunil V; Gajic, Ognjen (October 2008).
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Bistola, Vasiliki; Arfaras-Melainis, Angelos; Polyzogopoulou, Eftihia; Ikonomidis, Ignatios; Parissis, John (2019-11-04).
2356: 837:, detrimental heart structure remodelling, and even mortality. Heart failure can manifest in its life-threatening form of 1900:
Beard, Nicole A.; Wei, Lan; Cheung, Stephanie N.; Kimura, Takashi; Varsányi, Magdolna; Dulhunty, Angela F. (2008-10-01).
2381:"Increased Venous Return - Circulatory Effects - Physiological Effects Of Massage - Massage - Treatments - Physio.co.uk" 257: 3934:
Silvetti, Simona; Silvani, Paolo; Azzolini, Maria Luisa; Dossi, Roberto; Landoni, Giovanni; Zangrillo, Alberto (2015).
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Similar to the MoA of cardiac glycosides, elevated Ca2+ eventually translates into stronger cardiac contractile force.
323:, which is a compartment within cells that acts as the Ca2+ storage site. Phosphorylation results in the activation of 2816:"Pathophysiology of visual disorders induced by phosphodiesterase inhibitors in the treatment of erectile dysfunction" 2766: 575: 405: 39: 822: 285: 648: 100: 5084: 2987: 882: 3455:"Levosimendan as rescue therapy in low output syndrome after cardiac surgery: effects and predictors of outcome" 2875:"The role of cilostazol, a phosphodiesterase 3 inhibitor, on oocyte maturation and subsequent pregnancy in mice" 1423:
D, Anandhi; Pandit, Vinay R.; Kadhiravan, Tamilarasu; R, Soundaravally; Prakash Raju, K. N. J. (February 2019).
300:. Thus, beta-agonists will lead to elevated cAMP levels, which further activate a cAMP-dependent protein called 84: 4354:"Inotropes in Acute Heart Failure: From Guidelines to Practical Use: Therapeutic Options and Clinical Practice" 115: 2873:
Li, Min; Yu, Yang; Yan, Jie; Yan, Li-Ying; Zhao, Yue; Li, Rong; Liu, Ping; Hsueh, Aaron J.; Qiao, Jie (2012).
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Specifically, in patients experiencing inadequate blood perfusion (with blood pressure below 80 mmHg), the
3558:"Levosimendan: A calcium-sensitizing agent for the treatment of patients with decompensated heart failure" 743: 569: 410: 320: 309: 293: 108: 1390: 1094: 971: 657:
electrical signals that trigger the release of calcium ions. These calcium ions bind to a protein called
878: 771: 437: 292:, activation of Gs proteins ultimately activates adenylyl cyclase, which is responsible for converting 2015: 1901: 2886: 2742: 1733: 1292: 906: 228: 3750: 237:
Breastfeeding: amount found in breast milk is insignificant, harm caused to foetus not well studied
2714: 2558: 918: 781: 493: 485: 180: 3013:"The calcium sensitizer drug MCI-154 binds the structural C-terminal domain of cardiac troponin C" 3879:"Levosimendan Improves Clinical Outcomes of Refractory Heart Failure in Elderly Chinese Patients" 324: 1351: 901:
patients who remain symptomatic despite receiving treatment with a first-line combination of an
4085:"Why has positive inotropy failed in chronic heart failure? Lessons from prior inotrope trials" 2173: 5060: 5042: 5003: 4985: 4945: 4927: 4838: 4830: 4780: 4772: 4733: 4725: 4651: 4643: 4593: 4575: 4534: 4516: 4472: 4454: 4410: 4383: 4334: 4316: 4276: 4258: 4218: 4200: 4161: 4122: 4104: 4064: 4056: 4006: 3998: 3963: 3955: 3916: 3898: 3835: 3817: 3778: 3770: 3731: 3713: 3644: 3626: 3585: 3577: 3538: 3492: 3474: 3435: 3417: 3375: 3357: 3292: 3274: 3235: 3227: 3167: 3149: 3110: 3092: 3050: 3032: 2969: 2961: 2922: 2904: 2855: 2837: 2693: 2675: 2604: 2535: 2517: 2475: 2457: 2413: 2306: 2252: 2206: 2147: 2139: 1988: 1970: 1929: 1921: 1882: 1864: 1824: 1806: 1767: 1749: 1701: 1683: 1636: 1604: 1558: 1540: 1452: 1444: 1398: 1320: 1312: 1235: 1217: 1177: 1159: 1110: 1075: 1057: 1013: 979: 838: 803: 738: 683: 451: 392: 92: 59: 31: 5050: 5034: 4993: 4977: 4935: 4919: 4820: 4812: 4764: 4715: 4707: 4633: 4625: 4583: 4565: 4524: 4506: 4462: 4446: 4373: 4365: 4324: 4308: 4266: 4250: 4208: 4192: 4153: 4112: 4096: 4046: 4038: 3990: 3947: 3906: 3890: 3825: 3809: 3762: 3721: 3703: 3671: 3634: 3616: 3569: 3530: 3518: 3482: 3466: 3425: 3407: 3365: 3347: 3282: 3266: 3157: 3141: 3100: 3084: 3040: 3024: 2953: 2912: 2894: 2845: 2827: 2683: 2667: 2525: 2509: 2465: 2449: 2242: 2131: 1978: 1960: 1949:"The Sarcoplasmic Reticulum of Skeletal Muscle Cells: A Labyrinth of Membrane Contact Sites" 1913: 1872: 1856: 1814: 1798: 1757: 1741: 1691: 1673: 1548: 1532: 1436: 1304: 1225: 1209: 1167: 1151: 1138:
Eisner, David A.; Caldwell, Jessica L.; Kistamás, Kornél; Trafford, Andrew W. (2017-07-07).
1102: 1065: 1049: 676: 504: 301: 289: 281: 1722:"Evidence for functional pre-coupled complexes of receptor heteromers and adenylyl cyclase" 66:. These conditions arise when the heart's ability to meet the body's needs is compromised. 4752: 442: 304:. PK-A plays a pivotal role in increasing intracellular Ca2+ levels through 2 mechanisms: 3519:"Unusual Excessive Swelling of the Tongue after Calcium Acetate Ingestion: A Case Report" 861:(vasoconstrictive) functions to constrict blood vessels to correct hypotension. Whereas, 4940: 4907: 4800: 4695: 4613: 4529: 4494: 4026: 3430: 3395: 2890: 1737: 261:
General mechanism of action of beta-adrenergic agonists: activation of β1 / β2 receptors
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In our heart muscle cells, when the levels of cAMP rise, it activates a protein called
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Mechanism of action of calcium sensitizers: increase sensitivity of troponin C to Ca2+
5078: 4856: 3675: 3270: 2957: 2453: 1787:"Cross-talk between calcium and protein kinase A in the regulation of cell migration" 902: 854: 733: 565: 382: 176: 130: 63: 55: 42:, and calcium sensitizers. It is important to note that certain medications, such as 946: 4435:"A Clinical Update on Vasoactive Medication in the Management of Cardiogenic Shock" 2085: 910: 874: 760: 718: 687: 512: 428: 3813: 3145: 1440: 1155: 88:
Mechanism of action of cardiac glycosides (Digitalis): inhibition of Na+/K+ ATPase
4923: 4753:"The Effect of Digoxin on Mortality and Morbidity in Patients with Heart Failure" 3981:
Hansen, Benjamin Lautrup; Kristensen, Søren Lund; Gustafsson, Finn (2024-01-18).
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Liu, Peng; Wang, Lu; Han, Dan; Sun, Chaofeng; Xue, Xiaolin; Li, Guoliang (2020).
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Immediate use in cardiogenic shock or severe hypotension at risk of organ damage
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Ottolia, Michela; John, Scott; Hazan, Adina; Goldhaber, Joshua I. (2021-12-29).
921:- a heart rhythm disorder characterised by irregular electrical impulses in the 858: 790:
Positive effects in improving cardiac functions in paediatric (young) patients
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on the surface of SR, resulting in Ca2+ release from this compartment into the
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Compromised liver or kidney function with drugs that inhibit an enzyme called
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van der Lee, Robin; Peels, Barbara; Koopman-Esseboom, Corine (January 2017).
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Furthermore, calcium sensitizers provide an additional benefit. They open
4965: 3412: 2832: 2231:"Current use and advances in vasopressors and inotropes support in shock" 2174:"Adrenergic Agonists (Sympathomimetics) Nursing Pharmacology Study Guide" 1965: 1291:
Gheorghiade, Mihai; Adams, Kirkwood F.; Colucci, Wilson S. (2004-06-22).
1053: 947:"Cases | Pharmacotherapy Principles & Practice | McGraw Hill Medical" 850: 658: 519: 372: 331:(the universal fluid that bathes the different compartments inside cells) 23: 4570: 3894: 3621: 3605:"Use of Levosimendan in Patients with Advanced Heart Failure: An Update" 2050: 690:
and improved blood flow. This action reduces the workload on the heart.
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results in their activation, leading to extracellular Ca2+ influx into
161: 96: 47: 4816: 4711: 4638: 4629: 4100: 4042: 3994: 2271:"Phosphodiesterase III Inhibitor - an overview | ScienceDirect Topics" 2197:
VanValkinburgh, Danny; Kerndt, Connor C.; Hashmi, Muhammad F. (2024),
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Moreover, cardiomyocytes possess another surface protein known as the
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Zhang, Dengqing; Yao, Yuanqing; Qian, Jun; Huang, Jing (2015-08-20).
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Gresele, Paolo; Momi, Stefania; Falcinelli, Emanuela (October 2011).
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American Heart Association / American College of Cardiology (ACC/AHA)
673: 629: 612: 288:. Due to the coupling nature between β1, Gs proteins, and the enzyme 4157: 3982: 477:
Mechanism of action of PDE III inhibitors: inhibition of PDE3 enzyme
3336:"Arterial pulmonary hypertension in noncardiac intensive care unit" 2940:
Lehmann, Andreas; Boldt, Joachim; Kirchner, Jürgen (October 2003).
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Pirahanchi, Yasaman; Jessu, Rishita; Aeddula, Narothama R. (2024),
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Renally impaired: consider reducing initial and maintenance doses
2942:"The role of Ca++-sensitizers for the treatment of heart failure" 488:. This enzyme is responsible for breaking down a molecule called 484:
exert their effects by blocking the activity of an enzyme called
5027:
European Heart Journal - Quality of Care & Clinical Outcomes
2743:"How Do PDE-3 Inhibitors Work? - Uses, Side Effects, Drug Names" 1093:
Ohtsuki, Iwao; Morimoto, Sachio; Kitainda, Vivian (2021-01-01),
500:
is prevented, leading to increased levels of cAMP in our cells.
4554:"Inotropes do not increase mortality in advanced heart failure" 3798:"Acquired long QT syndrome in chronic kidney disease patients" 2086:"Dopamine: Side Effects, Uses, Dosage, Interactions, Warnings" 1495:"Pregnancy, breastfeeding and fertility while taking digoxin" 817:
Cardiogenic shock leads to many harmful physiological effects
788:
Compelling indication in elderly patients with heart failure
518:
Furthermore, PDE3 inhibitors exhibit an additional effect on
4401:
Kosaraju, Ateet; Pendela, Venkata Satish; Hai, Ofek (2024),
4181:"Role of Inotropic Agents in the Treatment of Heart Failure" 3936:"A systematic review on levosimendan in paediatric patients" 1595:
Farzam, Khashayar; Kidron, Ariel; Lakhkar, Anand D. (2024),
1038:"The Cardiac Na+-Ca2+ Exchanger: From Structure to Function" 1140:"Calcium and Excitation-Contraction Coupling in the Heart" 4179:
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2988:"Calcium Sensitizer - an overview | ScienceDirect Topics" 492:, which is the key signalling molecule in our body. When 1099:
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Saunders Handbook of Veterinary Drugs (Fourth Edition)
632:, which are specialized reproductive cells in females 235:
Pregnancy: can be used, may require dosage adjustment
4495:"Management of cardiogenic shock: a narrative review" 2791:"PDE3 Inhibitor - an overview | ScienceDirect Topics" 2559:"PDE3 Inhibitor - an overview | ScienceDirect Topics" 2438:"Anti-platelet therapy: phosphodiesterase inhibitors" 1389:
Papich, Mark G. (2016-01-01), Papich, Mark G. (ed.),
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Encyclopedia of Biological Chemistry (Second Edition)
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Heart failure patients are stratified based on their
661:, which initiates the process of muscle contraction. 125:
is significant, as it prepares muscle fibres for the
3071:
Kuo, Ivana Y.; Ehrlich, Barbara E. (February 2015).
2351: 2349: 1471:"Cardiovascular Disease Medication During Pregnancy" 284:
are a subunit of a large family of receptors called
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Saunders, pp. 241–242, 216:(blood flow to heart muscle suddenly blocked) 4670:"Ejection Fraction Heart Failure Measurement" 3459:The Journal of International Medical Research 978:, Waltham: Academic Press, pp. 681–687, 607:Psychological disorder (for example anxiety) 26:or stimulants, have a positive impact on the 8: 4751:Digitalis Investigation Group (1997-02-20). 4140:Bistola, V.; Chioncel, O. (September 2017). 2496:Zhang, Wei; Colman, Robert W. (2007-09-01). 1627:Alhayek, Soubhi; Preuss, Charles V. (2024), 1133: 1131: 736:(but no significant reduction in mortality) 177:Heart failure with reduced ejection fraction 4882:"Atrial fibrillation - Symptoms and causes" 970:Haviv, H.; Karlish, S. J. D. (2013-01-01), 915:mineralocorticoid receptor antagonist (MRA) 595:(heart rate too fast) Rapid drop in Weight 413:(malfunction in heart's electrical system) 4552:Guglin, Maya; Kaufman, Marc (2014-05-20). 3077:Cold Spring Harbor Perspectives in Biology 2595:Padda, Inderbir S.; Tripp, Jayson (2024), 2297:Padda, Inderbir S.; Tripp, Jayson (2024), 2124:Journal of Allergy and Clinical Immunology 5054: 4997: 4939: 4824: 4719: 4637: 4587: 4569: 4558:International Journal of General Medicine 4528: 4510: 4466: 4377: 4328: 4270: 4212: 4116: 4050: 3910: 3829: 3725: 3707: 3638: 3620: 3486: 3429: 3411: 3369: 3351: 3286: 3161: 3104: 3044: 2916: 2898: 2849: 2831: 2687: 2529: 2469: 2246: 1982: 1964: 1876: 1818: 1761: 1695: 1677: 1552: 1229: 1171: 1069: 917:. It is also considered in patients with 319:Phosphorylation at specific sites on the 62:, as well as for long-term management of 2442:British Journal of Clinical Pharmacology 812: 697: 686:in the heart muscle cells, resulting in 647: 529: 472: 342: 256: 140: 83: 2404:Ramanlal, Riddhi; Gupta, Vikas (2024), 2172:RN, Iris Dawn Tabangcora (2017-07-11). 938: 4488: 4486: 4439:Clinical Medicine Insights. 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(December 2002). 1006:"Physiology, Sodium Potassium Pump" 806:(lower chambers of the heart), low 286:G-protein-coupled receptors (GPCRs) 116:sodium-calcium (Na+/Ca2+) exchanger 4142:"Inotropes in acute heart failure" 1309:10.1161/01.CIR.0000132482.95686.87 1107:10.1016/b978-0-12-819460-7.00204-8 890:left ventricular ejection fraction 14: 4805:European Journal of Heart Failure 4700:European Journal of Heart Failure 4618:European Journal of Heart Failure 4197:10.1161/CIRCULATIONAHA.109.899294 4089:European Journal of Heart Failure 4031:European Journal of Heart Failure 3952:10.2174/1570161112666141127163536 3767:10.1161/CIRCULATIONAHA.105.542407 3073:"Signaling in Muscle Contraction" 1202:European Journal of Heart Failure 1095:"Structural Proteins | Troponin☆" 121:The interaction between Ca2+ and 3676:10.1046/j.1365-2230.2003.01141.x 3271:10.1111/j.1476-5381.2010.00680.x 2958:10.1097/00075198-200310000-00002 2946:Current Opinion in Critical Care 2454:10.1111/j.1365-2125.2011.04034.x 857:contribute mainly through their 445:(clogging of blood vessel wall) 40:phosphodiesterase III inhibitors 4757:New England Journal of Medicine 4297:"Treatments targeting inotropy" 4146:Continuing Cardiology Education 3259:British Journal of Pharmacology 2120:"Adverse effects of β-agonists" 1791:Current Opinion in Cell Biology 883:left ventricular assist devices 496:is inhibited, the breakdown of 3556:Lehtonen, Lasse (2004-09-01). 3523:Eurasian Journal of Toxicology 3214:Sakata, Yasushi (April 2013). 2715:"Phosphodiesterase inhibitors" 2597:"Phosphodiesterase Inhibitors" 2299:"Phosphodiesterase Inhibitors" 1785:Howe, Alan K. 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Using 1: 3940:Current Vascular Pharmacology 3814:10.1080/0886022X.2019.1707098 3562:Current Heart Failure Reports 3146:10.1080/19336950.2015.1076597 1441:10.1080/15563650.2018.1499930 1156:10.1161/CIRCRESAHA.117.310230 972:"P-Type Pumps: Na+,K+-ATPase" 769:Renal and hepatic impairment 208:Impaired renal function 4924:10.1161/CIR.0000000000001193 3609:Journal of Clinical Medicine 2900:10.1371/journal.pone.0030649 2514:10.1182/blood-2006-10-052522 2199:"Inotropes and Vasopressors" 896:, among cardiotonic agents, 590:Gastrointestinal discomfort 265:Naturally produced hormones 4769:10.1056/NEJM199702203360801 4255:10.1136/bmjopen-2021-053254 3089:10.1101/cshperspect.a006023 3029:10.1016/j.bbrep.2018.10.012 576:Peripheral Vascular Disease 438:Acute myocardial infarction 406:Decompensated heart failure 321:sarcoplasmic reticulum (SR) 273:or synthetic drugs such as 248:2) Beta-adrenergic agonists 5106: 4512:10.1186/s13613-024-01260-y 2406:"Physiology, Vasodilation" 2016:"Beta-agonist Medications" 1918:10.1016/j.ceca.2008.01.005 1746:10.1038/s41467-018-03522-3 765:Injection site irritation 325:ryanodine receptors (RyRs) 127:sliding filament mechanism 5090:Cardiovascular physiology 4451:10.1177/11795468221075064 3574:10.1007/s11897-004-0023-6 2248:10.21037/jeccm.2019.12.03 1861:10.1126/scisignal.aaf9647 1803:10.1016/j.ceb.2011.05.006 1679:10.1186/s12915-018-0491-x 1352:"Side effects of digoxin" 752:Isolated tongue swelling 16:Class of heart medication 4499:Annals of Intensive Care 4313:10.1093/eurheartj/ehy600 3471:10.1177/0300060519835087 1097:, in Jez, Joseph (ed.), 1042:Comprehensive Physiology 825:, recommends the use of 420:(abnormal heart rhythm) 183:(abnormal heart rhythm) 99:, primarily inhibit the 36:beta-adrenergic agonists 22:, also known as cardiac 5039:10.1093/ehjqcco/qcaa061 3883:Medical Science Monitor 3709:10.3389/fonc.2020.00779 2136:10.1067/mai.2002.129966 694:Pharmacotherapy profile 526:Pharmacotherapy profile 339:Pharmacotherapy profile 302:protein-kinase A (PK-A) 219:Electrolyte disorders ( 214:Acute coronary syndrome 137:Pharmacotherapy profile 4982:10.1001/jama.2020.0734 4370:10.15420/cfr.2019.11.2 4358:Cardiac Failure Review 4301:European Heart Journal 3535:10.51262/ejtox.1236194 3130:"Cardiac ion channels" 818: 776:Patients with prolong 744:Pulmonary Hypertension 653: 639:4) Calcium sensitisers 570:Pulmonary Hypertension 505:protein kinase A (PKA) 478: 411:Atrioventricular block 262: 89: 4857:"Atrial fibrillation" 4445:: 11795468221075064. 3696:Frontiers in Oncology 3315:www.heartrecovery.com 2992:www.sciencedirect.com 2795:www.sciencedirect.com 2660:Clinical Case Reports 2563:www.sciencedirect.com 2361:www.sciencedirect.com 2334:www.sciencedirect.com 2275:www.sciencedirect.com 1726:Nature Communications 1537:10.3892/etm.2014.2013 816: 772:Electrolyte imbalance 748:Post-Cardiac Surgery 651: 476: 260: 87: 75:1) Cardiac Glycosides 58:conditions including 3413:10.3390/jcdd10080332 2833:10.2147/DDDT.S118015 1966:10.3390/biom12040488 1144:Circulation Research 1054:10.1002/cphy.c200031 713:Special populations 707:Common side effects 545:Special populations 539:Common side effects 358:Special populations 352:Common side effects 349:General Indications 310:L-type Ca2+ channels 156:Special populations 150:Common side effects 147:General indications 4571:10.2147/IJGM.S62549 4403:"Cardiogenic Shock" 3895:10.12659/MSM.893580 3858:www.medsafe.govt.nz 3622:10.3390/jcm11216408 2891:2012PLoSO...730649L 1738:2018NatCo...9.1242N 1429:Clinical Toxicology 919:atrial fibrillation 644:Mechanism of action 469:Mechanism of action 402:Severe hypotension 308:Phosphorylation of 253:Mechanism of action 181:Atrial Fibrillation 80:Mechanism of action 56:acute heart failure 3353:10.2147/vhrm.s3998 1629:"Beta 1 Receptors" 1597:"Adrenergic Drugs" 819: 684:potassium channels 654: 479: 389:Anaphylactic shock 263: 210:Thyroid disorders 93:Cardiac glycosides 90: 32:cardiac glycosides 20:Cardiotonic agents 4817:10.1002/ejhf.2333 4712:10.1002/ejhf.2333 4630:10.1002/ejhf.2814 4307:(44): 3626–3644. 4191:(14): 1655–1660. 4101:10.1002/ejhf.1557 4043:10.1002/ejhf.2333 3995:10.1159/000536373 1855:(463): eaaf9647. 1849:Science Signaling 1404:978-0-323-24485-5 1303:(24): 2959–2964. 1214:10.1002/ejhf.1452 1116:978-0-12-822040-5 985:978-0-12-378631-9 951:ppp.mhmedical.com 839:cardiogenic shock 795: 794: 739:Cardiogenic Shock 636: 635: 461: 460: 452:Diabetes mellitus 393:Cardiogenic shock 245: 244: 198:Vision disorders 60:cardiogenic shock 5097: 5085:Inotropic agents 5069: 5068: 5058: 5018: 5012: 5011: 5001: 4960: 4954: 4953: 4943: 4902: 4896: 4895: 4893: 4892: 4878: 4872: 4871: 4869: 4868: 4853: 4847: 4846: 4828: 4795: 4789: 4788: 4748: 4742: 4741: 4723: 4690: 4684: 4683: 4681: 4680: 4666: 4660: 4659: 4641: 4608: 4602: 4601: 4591: 4573: 4549: 4543: 4542: 4532: 4514: 4490: 4481: 4480: 4470: 4430: 4424: 4423: 4422: 4421: 4398: 4392: 4391: 4381: 4349: 4343: 4342: 4332: 4291: 4285: 4284: 4274: 4233: 4227: 4226: 4216: 4176: 4170: 4169: 4137: 4131: 4130: 4120: 4095:(9): 1064–1078. 4079: 4073: 4072: 4054: 4021: 4015: 4014: 3978: 3972: 3971: 3931: 3925: 3924: 3914: 3874: 3868: 3867: 3865: 3864: 3850: 3844: 3843: 3833: 3793: 3787: 3786: 3746: 3740: 3739: 3729: 3711: 3686: 3680: 3679: 3659: 3653: 3652: 3642: 3624: 3600: 3594: 3593: 3553: 3547: 3546: 3514: 3501: 3500: 3490: 3465:(8): 3502–3512. 3450: 3444: 3443: 3433: 3415: 3390: 3384: 3383: 3373: 3355: 3346:(5): 1043–1060. 3331: 3325: 3324: 3322: 3321: 3307: 3301: 3300: 3290: 3250: 3244: 3243: 3220:Clinical Calcium 3211: 3205: 3204: 3202: 3201: 3187: 3176: 3175: 3165: 3125: 3119: 3118: 3108: 3068: 3059: 3058: 3048: 3008: 3002: 3001: 2999: 2998: 2984: 2978: 2977: 2937: 2931: 2930: 2920: 2902: 2870: 2864: 2863: 2853: 2835: 2811: 2805: 2804: 2802: 2801: 2787: 2781: 2780: 2778: 2777: 2771:Cleveland Clinic 2763: 2757: 2756: 2754: 2753: 2739: 2730: 2729: 2727: 2726: 2711: 2702: 2701: 2691: 2672:10.1002/ccr3.748 2651: 2642: 2641: 2639: 2638: 2624: 2618: 2617: 2616: 2615: 2592: 2573: 2572: 2570: 2569: 2555: 2544: 2543: 2533: 2508:(5): 1475–1482. 2493: 2484: 2483: 2473: 2433: 2427: 2426: 2425: 2424: 2401: 2395: 2394: 2392: 2391: 2385:www.physio.co.uk 2377: 2371: 2370: 2368: 2367: 2353: 2344: 2343: 2341: 2340: 2326: 2320: 2319: 2318: 2317: 2294: 2285: 2284: 2282: 2281: 2267: 2261: 2260: 2250: 2226: 2220: 2219: 2218: 2217: 2194: 2188: 2187: 2185: 2184: 2169: 2156: 2155: 2130:(6): S322–S328. 2115: 2100: 2099: 2097: 2096: 2082: 2065: 2064: 2062: 2061: 2047: 2030: 2029: 2027: 2026: 2020:Cleveland Clinic 2012: 1997: 1996: 1986: 1968: 1944: 1938: 1937: 1897: 1891: 1890: 1880: 1839: 1833: 1832: 1822: 1782: 1776: 1775: 1765: 1716: 1710: 1709: 1699: 1681: 1656: 1650: 1649: 1648: 1647: 1624: 1618: 1617: 1616: 1615: 1592: 1567: 1566: 1556: 1531:(6): 1689–1694. 1516: 1510: 1509: 1507: 1506: 1491: 1485: 1484: 1482: 1481: 1467: 1461: 1460: 1420: 1414: 1413: 1412: 1411: 1386: 1367: 1366: 1364: 1363: 1348: 1329: 1328: 1288: 1273: 1272: 1270: 1269: 1263:Cleveland Clinic 1255: 1244: 1243: 1233: 1192: 1186: 1185: 1175: 1135: 1126: 1125: 1124: 1123: 1090: 1084: 1083: 1073: 1048:(1): 2681–2717. 1033: 1027: 1026: 1025: 1024: 1001: 995: 994: 993: 992: 967: 961: 960: 958: 957: 943: 698: 620:(eye disorders) 530: 343: 314:cardiac myocytes 290:adenylyl cyclase 141: 123:Troponin C (TnC) 5105: 5104: 5100: 5099: 5098: 5096: 5095: 5094: 5075: 5074: 5073: 5072: 5020: 5019: 5015: 4962: 4961: 4957: 4904: 4903: 4899: 4890: 4888: 4880: 4879: 4875: 4866: 4864: 4855: 4854: 4850: 4797: 4796: 4792: 4750: 4749: 4745: 4692: 4691: 4687: 4678: 4676: 4668: 4667: 4663: 4610: 4609: 4605: 4551: 4550: 4546: 4492: 4491: 4484: 4432: 4431: 4427: 4419: 4417: 4400: 4399: 4395: 4351: 4350: 4346: 4293: 4292: 4288: 4235: 4234: 4230: 4178: 4177: 4173: 4158:10.1002/cce2.59 4139: 4138: 4134: 4081: 4080: 4076: 4023: 4022: 4018: 3980: 3979: 3975: 3933: 3932: 3928: 3876: 3875: 3871: 3862: 3860: 3852: 3851: 3847: 3795: 3794: 3790: 3748: 3747: 3743: 3688: 3687: 3683: 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2055:go.drugbank.com 2049: 2048: 2033: 2024: 2022: 2014: 2013: 2000: 1946: 1945: 1941: 1899: 1898: 1894: 1841: 1840: 1836: 1784: 1783: 1779: 1718: 1717: 1713: 1658: 1657: 1653: 1645: 1643: 1626: 1625: 1621: 1613: 1611: 1594: 1593: 1570: 1518: 1517: 1513: 1504: 1502: 1493: 1492: 1488: 1479: 1477: 1469: 1468: 1464: 1422: 1421: 1417: 1409: 1407: 1405: 1388: 1387: 1370: 1361: 1359: 1350: 1349: 1332: 1290: 1289: 1276: 1267: 1265: 1257: 1256: 1247: 1194: 1193: 1189: 1137: 1136: 1129: 1121: 1119: 1117: 1092: 1091: 1087: 1035: 1034: 1030: 1022: 1020: 1003: 1002: 998: 990: 988: 986: 969: 968: 964: 955: 953: 945: 944: 940: 935: 804:left ventricles 800: 696: 646: 641: 586:(lung disease) 528: 482:PDE3 inhibitors 471: 466: 443:Atherosclerosis 440:(heart attack) 341: 255: 250: 139: 82: 77: 72: 17: 12: 11: 5: 5103: 5101: 5093: 5092: 5087: 5077: 5076: 5071: 5070: 5033:(6): 574–582. 5013: 4976:(9): 863–884. 4955: 4918:(1): e1–e156. 4897: 4873: 4848: 4790: 4763:(8): 525–533. 4743: 4685: 4661: 4624:(4): 457–468. 4603: 4544: 4482: 4425: 4393: 4364:(3): 133–139. 4344: 4286: 4249:(1): e053254. 4228: 4171: 4152:(3): 107–116. 4132: 4074: 4016: 3973: 3946:(1): 128–133. 3926: 3869: 3845: 3788: 3761:(2): 305–315. 3741: 3681: 3654: 3595: 3568:(3): 136–144. 3548: 3502: 3445: 3385: 3326: 3302: 3265:(1): 142–152. 3245: 3226:(4): 575–582. 3206: 3177: 3140:(6): 352–359. 3120: 3083:(2): a006023. 3060: 3003: 2979: 2952:(5): 337–344. 2932: 2865: 2806: 2782: 2758: 2731: 2703: 2643: 2619: 2574: 2545: 2485: 2448:(4): 634–646. 2428: 2396: 2372: 2345: 2321: 2286: 2262: 2221: 2189: 2157: 2101: 2066: 2031: 1998: 1939: 1912:(4): 363–373. 1892: 1843:(2017-01-24). 1834: 1797:(5): 554–561. 1777: 1711: 1651: 1619: 1568: 1511: 1486: 1462: 1435:(2): 104–111. 1415: 1403: 1368: 1330: 1274: 1245: 1208:(5): 676–684. 1187: 1150:(2): 181–195. 1127: 1115: 1085: 1028: 996: 984: 962: 937: 936: 934: 931: 843:Norepinephrine 808:cardiac output 799: 796: 793: 792: 786: 767: 750: 731: 715: 714: 711: 708: 705: 702: 701:Drug examples 695: 692: 645: 642: 640: 637: 634: 633: 622: 618:ophthalmopathy 609: 588: 563: 547: 546: 543: 540: 537: 534: 533:Drug examples 527: 524: 470: 467: 465: 462: 459: 458: 455: 435: 415: 398:Cardiac arrest 386: 368:Norepinephrine 360: 359: 356: 353: 350: 347: 346:Drug examples 340: 337: 333: 332: 317: 267:norepinephrine 254: 251: 249: 246: 243: 242: 233: 229:hypomagnesemia 206: 185: 174: 158: 157: 154: 151: 148: 145: 144:Drug examples 138: 135: 105:cardiomyocytes 81: 78: 76: 73: 71: 70:Classification 68: 15: 13: 10: 9: 6: 4: 3: 2: 5102: 5091: 5088: 5086: 5083: 5082: 5080: 5066: 5062: 5057: 5052: 5048: 5044: 5040: 5036: 5032: 5028: 5024: 5017: 5014: 5009: 5005: 5000: 4995: 4991: 4987: 4983: 4979: 4975: 4971: 4967: 4959: 4956: 4951: 4947: 4942: 4937: 4933: 4929: 4925: 4921: 4917: 4913: 4909: 4901: 4898: 4887: 4883: 4877: 4874: 4862: 4858: 4852: 4849: 4844: 4840: 4836: 4832: 4827: 4822: 4818: 4814: 4810: 4806: 4802: 4794: 4791: 4786: 4782: 4778: 4774: 4770: 4766: 4762: 4758: 4754: 4747: 4744: 4739: 4735: 4731: 4727: 4722: 4717: 4713: 4709: 4705: 4701: 4697: 4689: 4686: 4675: 4674:www.heart.org 4671: 4665: 4662: 4657: 4653: 4649: 4645: 4640: 4635: 4631: 4627: 4623: 4619: 4615: 4607: 4604: 4599: 4595: 4590: 4585: 4581: 4577: 4572: 4567: 4563: 4559: 4555: 4548: 4545: 4540: 4536: 4531: 4526: 4522: 4518: 4513: 4508: 4504: 4500: 4496: 4489: 4487: 4483: 4478: 4474: 4469: 4464: 4460: 4456: 4452: 4448: 4444: 4440: 4436: 4429: 4426: 4416: 4412: 4408: 4404: 4397: 4394: 4389: 4385: 4380: 4375: 4371: 4367: 4363: 4359: 4355: 4348: 4345: 4340: 4336: 4331: 4326: 4322: 4318: 4314: 4310: 4306: 4302: 4298: 4290: 4287: 4282: 4278: 4273: 4268: 4264: 4260: 4256: 4252: 4248: 4244: 4240: 4232: 4229: 4224: 4220: 4215: 4210: 4206: 4202: 4198: 4194: 4190: 4186: 4182: 4175: 4172: 4167: 4163: 4159: 4155: 4151: 4147: 4143: 4136: 4133: 4128: 4124: 4119: 4114: 4110: 4106: 4102: 4098: 4094: 4090: 4086: 4078: 4075: 4070: 4066: 4062: 4058: 4053: 4048: 4044: 4040: 4036: 4032: 4028: 4020: 4017: 4012: 4008: 4004: 4000: 3996: 3992: 3988: 3984: 3977: 3974: 3969: 3965: 3961: 3957: 3953: 3949: 3945: 3941: 3937: 3930: 3927: 3922: 3918: 3913: 3908: 3904: 3900: 3896: 3892: 3889:: 2439–2445. 3888: 3884: 3880: 3873: 3870: 3859: 3855: 3849: 3846: 3841: 3837: 3832: 3827: 3823: 3819: 3815: 3811: 3807: 3803: 3802:Renal Failure 3799: 3792: 3789: 3784: 3780: 3776: 3772: 3768: 3764: 3760: 3756: 3752: 3745: 3742: 3737: 3733: 3728: 3723: 3719: 3715: 3710: 3705: 3701: 3697: 3693: 3685: 3682: 3677: 3673: 3669: 3665: 3658: 3655: 3650: 3646: 3641: 3636: 3632: 3628: 3623: 3618: 3614: 3610: 3606: 3599: 3596: 3591: 3587: 3583: 3579: 3575: 3571: 3567: 3563: 3559: 3552: 3549: 3544: 3540: 3536: 3532: 3528: 3524: 3520: 3513: 3511: 3509: 3507: 3503: 3498: 3494: 3489: 3484: 3480: 3476: 3472: 3468: 3464: 3460: 3456: 3449: 3446: 3441: 3437: 3432: 3427: 3423: 3419: 3414: 3409: 3405: 3401: 3397: 3389: 3386: 3381: 3377: 3372: 3367: 3363: 3359: 3354: 3349: 3345: 3341: 3337: 3330: 3327: 3316: 3312: 3306: 3303: 3298: 3294: 3289: 3284: 3280: 3276: 3272: 3268: 3264: 3260: 3256: 3249: 3246: 3241: 3237: 3233: 3229: 3225: 3221: 3217: 3210: 3207: 3196: 3192: 3186: 3184: 3182: 3178: 3173: 3169: 3164: 3159: 3155: 3151: 3147: 3143: 3139: 3135: 3131: 3124: 3121: 3116: 3112: 3107: 3102: 3098: 3094: 3090: 3086: 3082: 3078: 3074: 3067: 3065: 3061: 3056: 3052: 3047: 3042: 3038: 3034: 3030: 3026: 3022: 3018: 3014: 3007: 3004: 2993: 2989: 2983: 2980: 2975: 2971: 2967: 2963: 2959: 2955: 2951: 2947: 2943: 2936: 2933: 2928: 2924: 2919: 2914: 2910: 2906: 2901: 2896: 2892: 2888: 2885:(1): e30649. 2884: 2880: 2876: 2869: 2866: 2861: 2857: 2852: 2847: 2843: 2839: 2834: 2829: 2826:: 3407–3413. 2825: 2821: 2817: 2810: 2807: 2796: 2792: 2786: 2783: 2772: 2768: 2762: 2759: 2748: 2744: 2738: 2736: 2732: 2720: 2716: 2710: 2708: 2704: 2699: 2695: 2690: 2685: 2681: 2677: 2673: 2669: 2665: 2661: 2657: 2650: 2648: 2644: 2633: 2629: 2623: 2620: 2610: 2606: 2602: 2598: 2591: 2589: 2587: 2585: 2583: 2581: 2579: 2575: 2564: 2560: 2554: 2552: 2550: 2546: 2541: 2537: 2532: 2527: 2523: 2519: 2515: 2511: 2507: 2503: 2499: 2492: 2490: 2486: 2481: 2477: 2472: 2467: 2463: 2459: 2455: 2451: 2447: 2443: 2439: 2432: 2429: 2419: 2415: 2411: 2407: 2400: 2397: 2386: 2382: 2376: 2373: 2362: 2358: 2352: 2350: 2346: 2335: 2331: 2325: 2322: 2312: 2308: 2304: 2300: 2293: 2291: 2287: 2276: 2272: 2266: 2263: 2258: 2254: 2249: 2244: 2240: 2236: 2232: 2225: 2222: 2212: 2208: 2204: 2200: 2193: 2190: 2179: 2175: 2168: 2166: 2164: 2162: 2158: 2153: 2149: 2145: 2141: 2137: 2133: 2129: 2125: 2121: 2114: 2112: 2110: 2108: 2106: 2102: 2091: 2087: 2081: 2079: 2077: 2075: 2073: 2071: 2067: 2056: 2052: 2046: 2044: 2042: 2040: 2038: 2036: 2032: 2021: 2017: 2011: 2009: 2007: 2005: 2003: 1999: 1994: 1990: 1985: 1980: 1976: 1972: 1967: 1962: 1958: 1954: 1950: 1943: 1940: 1935: 1931: 1927: 1923: 1919: 1915: 1911: 1907: 1903: 1896: 1893: 1888: 1884: 1879: 1874: 1870: 1866: 1862: 1858: 1854: 1850: 1846: 1838: 1835: 1830: 1826: 1821: 1816: 1812: 1808: 1804: 1800: 1796: 1792: 1788: 1781: 1778: 1773: 1769: 1764: 1759: 1755: 1751: 1747: 1743: 1739: 1735: 1731: 1727: 1723: 1715: 1712: 1707: 1703: 1698: 1693: 1689: 1685: 1680: 1675: 1671: 1667: 1663: 1655: 1652: 1642: 1638: 1634: 1630: 1623: 1620: 1610: 1606: 1602: 1598: 1591: 1589: 1587: 1585: 1583: 1581: 1579: 1577: 1575: 1573: 1569: 1564: 1560: 1555: 1550: 1546: 1542: 1538: 1534: 1530: 1526: 1522: 1515: 1512: 1500: 1496: 1490: 1487: 1476: 1472: 1466: 1463: 1458: 1454: 1450: 1446: 1442: 1438: 1434: 1430: 1426: 1419: 1416: 1406: 1400: 1396: 1392: 1385: 1383: 1381: 1379: 1377: 1375: 1373: 1369: 1357: 1353: 1347: 1345: 1343: 1341: 1339: 1337: 1335: 1331: 1326: 1322: 1318: 1314: 1310: 1306: 1302: 1298: 1294: 1287: 1285: 1283: 1281: 1279: 1275: 1264: 1260: 1254: 1252: 1250: 1246: 1241: 1237: 1232: 1227: 1223: 1219: 1215: 1211: 1207: 1203: 1199: 1191: 1188: 1183: 1179: 1174: 1169: 1165: 1161: 1157: 1153: 1149: 1145: 1141: 1134: 1132: 1128: 1118: 1112: 1108: 1104: 1100: 1096: 1089: 1086: 1081: 1077: 1072: 1067: 1063: 1059: 1055: 1051: 1047: 1043: 1039: 1032: 1029: 1019: 1015: 1011: 1007: 1000: 997: 987: 981: 977: 973: 966: 963: 952: 948: 942: 939: 932: 930: 928: 924: 920: 916: 912: 908: 904: 903:ACE inhibitor 899: 895: 891: 886: 884: 880: 876: 872: 868: 864: 860: 856: 855:phenylephrine 852: 848: 844: 840: 836: 832: 828: 824: 815: 811: 809: 805: 797: 791: 787: 785: 783: 779: 774: 773: 768: 766: 763: 762: 758: 755: 751: 749: 746: 745: 741: 740: 735: 734:Heart failure 732: 730: 729: 725: 724: 720: 717: 716: 712: 709: 706: 703: 700: 699: 693: 691: 689: 685: 680: 678: 675: 671: 667: 662: 660: 650: 643: 638: 631: 627: 623: 621: 619: 616:Pre-existing 614: 610: 608: 605: 602: 599: 596: 594: 589: 587: 585: 581: 578: 577: 573: 571: 567: 566:Heart Failure 564: 562: 561: 557: 556: 552: 549: 548: 544: 541: 538: 535: 532: 531: 525: 523: 521: 516: 514: 508: 506: 501: 499: 495: 491: 487: 483: 475: 468: 463: 456: 454: 453: 449: 446: 444: 439: 436: 434: 431: 430: 426: 425:Hypertension 423: 419: 416: 414: 412: 408: 407: 403: 400: 399: 395: 394: 390: 387: 385: 384: 383:Isoproterenol 380: 379: 375: 374: 370: 369: 365: 362: 361: 357: 354: 351: 348: 345: 344: 338: 336: 330: 326: 322: 318: 315: 311: 307: 306: 305: 303: 299: 295: 291: 287: 283: 279: 276: 272: 268: 259: 252: 247: 241: 238: 234: 232: 230: 226: 222: 221:hypercalcemia 217: 215: 211: 207: 205: 202: 199: 196: 193: 190: 186: 184: 182: 178: 175: 173: 172: 168: 167: 163: 160: 159: 155: 152: 149: 146: 143: 142: 136: 134: 132: 131:heart failure 128: 124: 119: 117: 112: 110: 106: 102: 98: 94: 86: 79: 74: 69: 67: 65: 64:heart failure 61: 57: 53: 49: 45: 41: 37: 33: 29: 25: 21: 5030: 5026: 5016: 4973: 4969: 4958: 4915: 4911: 4900: 4889:. Retrieved 4885: 4876: 4865:. Retrieved 4863:. 2017-10-20 4860: 4851: 4811:(1): 4–131. 4808: 4804: 4793: 4760: 4756: 4746: 4706:(1): 4–131. 4703: 4699: 4688: 4677:. Retrieved 4673: 4664: 4621: 4617: 4606: 4561: 4557: 4547: 4502: 4498: 4442: 4438: 4428: 4418:, retrieved 4406: 4396: 4361: 4357: 4347: 4304: 4300: 4289: 4246: 4242: 4231: 4188: 4184: 4174: 4149: 4145: 4135: 4092: 4088: 4077: 4037:(1): 4–131. 4034: 4030: 4019: 3986: 3976: 3943: 3939: 3929: 3886: 3882: 3872: 3861:. Retrieved 3857: 3848: 3808:(1): 54–65. 3805: 3801: 3791: 3758: 3754: 3744: 3699: 3695: 3684: 3670:(1): 34–36. 3667: 3663: 3657: 3615:(21): 6408. 3612: 3608: 3598: 3565: 3561: 3551: 3529:(1): 17–19. 3526: 3522: 3462: 3458: 3448: 3403: 3399: 3388: 3343: 3339: 3329: 3318:. Retrieved 3314: 3305: 3262: 3258: 3248: 3223: 3219: 3209: 3198:. Retrieved 3194: 3137: 3133: 3123: 3080: 3076: 3020: 3016: 3006: 2995:. Retrieved 2991: 2982: 2949: 2945: 2935: 2882: 2878: 2868: 2823: 2819: 2809: 2798:. Retrieved 2794: 2785: 2774:. Retrieved 2770: 2761: 2750:. Retrieved 2746: 2723:. Retrieved 2721:. 2023-07-14 2718: 2666:(1): 18–21. 2663: 2659: 2635:. Retrieved 2631: 2622: 2612:, retrieved 2600: 2566:. Retrieved 2562: 2505: 2501: 2445: 2441: 2431: 2421:, retrieved 2409: 2399: 2388:. Retrieved 2384: 2375: 2364:. Retrieved 2360: 2337:. Retrieved 2333: 2324: 2314:, retrieved 2302: 2278:. Retrieved 2274: 2265: 2238: 2234: 2224: 2214:, retrieved 2202: 2192: 2181:. Retrieved 2177: 2127: 2123: 2093:. Retrieved 2089: 2058:. Retrieved 2054: 2023:. Retrieved 2019: 1956: 1953:Biomolecules 1952: 1942: 1909: 1906:Cell Calcium 1905: 1895: 1852: 1848: 1837: 1794: 1790: 1780: 1729: 1725: 1714: 1669: 1665: 1654: 1644:, retrieved 1632: 1622: 1612:, retrieved 1600: 1528: 1524: 1514: 1503:. Retrieved 1501:. 2021-09-15 1498: 1489: 1478:. Retrieved 1474: 1465: 1432: 1428: 1418: 1408:, retrieved 1394: 1360:. Retrieved 1358:. 2021-09-15 1355: 1300: 1296: 1266:. Retrieved 1262: 1205: 1201: 1190: 1147: 1143: 1120:, retrieved 1098: 1088: 1045: 1041: 1031: 1021:, retrieved 1009: 999: 989:, retrieved 975: 965: 954:. Retrieved 950: 941: 911:beta-blocker 887: 875:levosimendan 820: 801: 789: 775: 770: 764: 759: 756: 753: 747: 742: 737: 726: 721: 719:Levosimendan 710:Precautions 704:Indications 688:vasodilation 681: 663: 655: 615: 606: 603: 600: 597: 591: 582: 579: 574: 568: 558: 553: 542:Precautions 536:Indications 517: 513:vasodilation 509: 502: 480: 450: 448:Arrhythmias 447: 441: 432: 429:Palpitations 427: 424: 421: 409: 404: 401: 396: 391: 381: 376: 371: 366: 355:Precautions 334: 280: 264: 239: 236: 218: 212: 209: 203: 201:Arrhythmias 200: 197: 195:Skin rashes 194: 191: 188: 179: 169: 164: 120: 113: 91: 19: 18: 4912:Circulation 4886:Mayo Clinic 4826:2434/966600 4721:2434/966600 4564:: 237–251. 4185:Circulation 4052:2434/966600 3755:Circulation 3023:: 145–151. 1732:(1): 1242. 1666:BMC Biology 1297:Circulation 879:transplants 859:vasopressor 847:epinephrine 835:arrhythmias 761:Palpitation 593:Tachycardia 422:Chest pain 418:Arrhythmias 364:Epinephrine 282:Gs proteins 271:epinephrine 225:hypokalemia 5079:Categories 4891:2024-04-05 4867:2024-04-05 4679:2024-04-05 4639:2183/37133 4420:2024-04-05 4407:StatPearls 3987:Cardiology 3863:2024-04-05 3406:(8): 332. 3320:2024-04-05 3200:2024-04-05 2997:2024-04-07 2800:2024-04-05 2776:2024-04-05 2752:2024-04-05 2725:2024-08-11 2637:2024-04-05 2614:2024-04-05 2601:StatPearls 2568:2024-04-05 2423:2024-04-07 2410:StatPearls 2390:2024-04-07 2366:2024-04-07 2339:2024-04-07 2316:2024-04-07 2303:StatPearls 2280:2024-04-07 2216:2024-04-05 2203:StatPearls 2183:2024-04-05 2178:Nurseslabs 2095:2024-04-05 2060:2024-04-05 2051:"Dopamine" 2025:2024-04-05 1959:(4): 488. 1646:2024-04-05 1633:StatPearls 1614:2024-04-05 1601:StatPearls 1505:2024-04-05 1480:2024-04-05 1410:2024-04-05 1362:2024-04-05 1268:2024-04-05 1122:2024-04-05 1023:2024-04-05 1010:StatPearls 991:2024-04-05 956:2024-04-05 933:References 863:dobutamine 827:Dobutamine 666:troponin C 601:Dizziness 598:Headaches 572:in babies 555:Cilostazol 551:Anagrelide 378:Dobutamine 275:dobutamine 192:Diarrhoea 187:Dizziness 28:myocardium 5047:2058-1742 4990:0098-7484 4932:0009-7322 4835:1388-9842 4777:0028-4793 4730:1388-9842 4648:1388-9842 4580:1178-7074 4521:2110-5820 4505:(1): 45. 4459:1179-5468 4321:0195-668X 4263:2044-6055 4205:0009-7322 4166:2059-1594 4109:1879-0844 4061:1388-9842 4003:0008-6312 3960:1875-6212 3903:1234-1010 3822:0886-022X 3775:0009-7322 3718:2234-943X 3631:2077-0383 3582:1546-9549 3543:2667-8675 3479:0300-0605 3422:2308-3425 3362:1176-6344 3279:0007-1188 3232:0917-5857 3154:1933-6950 3097:1943-0264 3037:2405-5808 2966:1070-5295 2909:1932-6203 2842:1177-8881 2680:2050-0904 2522:0006-4971 2462:0306-5251 2257:2521-3563 2144:0091-6749 1975:2218-273X 1926:0143-4160 1869:1945-0877 1811:0955-0674 1754:2041-1723 1688:1741-7007 1672:(1): 24. 1545:1792-0981 1449:1556-9519 1391:"Digoxin" 1317:0009-7322 1222:1388-9842 1164:0009-7330 1062:2040-4603 871:enoximone 867:milrinone 831:Milrinone 754:Headache 723:Milrinone 677:filaments 604:Insomnia 560:Milrinone 520:platelets 204:Vomiting 171:Digitoxin 166:Digitalis 153:Cautions 52:perfusion 44:Milrinone 24:inotropes 5065:32735316 5008:32125402 4950:38033089 4941:11095842 4843:35083827 4738:35083827 4656:36847113 4598:24899821 4539:38553663 4530:10980676 4477:35153521 4415:29489148 4388:31768269 4339:30295807 4281:35058261 4243:BMJ Open 4223:20385962 4127:31407860 4069:35083827 4011:38237564 3989:: 1–15. 3968:25440597 3921:26289557 3840:31878817 3783:16418450 3736:32509580 3649:36362634 3590:16036037 3497:30909776 3440:37623345 3431:10455812 3380:19183752 3297:20412071 3240:23545748 3172:26556552 3134:Channels 3115:25646377 3055:30417133 2974:14508145 2927:22292006 2879:PLOS ONE 2860:27799745 2698:28096983 2609:32644702 2540:17392505 2480:21649691 2418:32491494 2311:32644702 2211:29494018 2152:12464943 1993:35454077 1934:19230141 1887:28119464 1829:21665456 1772:29593213 1706:29486745 1641:30422499 1609:30480963 1563:25371716 1457:30073854 1325:15210613 1240:30892806 1182:28684623 1080:34964124 1018:30725773 913:, and a 851:dopamine 659:troponin 433:Anxiety 373:Dopamine 5056:8557444 4999:7054840 4785:9036306 4589:4038527 4468:8829716 4379:6848944 4330:7963133 4272:8783828 4214:2861129 4118:6774302 3912:4548701 3831:6968512 3727:7248368 3702:: 779. 3640:9659135 3488:6726822 3371:2605326 3288:2860214 3163:4850049 3106:4315934 3046:6218639 2918:3265514 2887:Bibcode 2851:5076796 2689:5224780 2531:1975837 2471:3195739 1984:9026860 1878:5297430 1820:3175278 1763:5871782 1734:Bibcode 1697:6389107 1554:4218698 1231:6607489 1173:5497788 1071:8773166 898:Digoxin 778:QT wave 757:Nausea 728:Digoxin 630:oocytes 626:meiosis 580:Asthma 329:cytosol 189:Nausea 162:Digoxin 97:digoxin 48:Digoxin 5063:  5053:  5045:  5006:  4996:  4988:  4948:  4938:  4930:  4861:nhs.uk 4841:  4833:  4783:  4775:  4736:  4728:  4654:  4646:  4596:  4586:  4578:  4537:  4527:  4519:  4475:  4465:  4457:  4413:  4386:  4376:  4337:  4327:  4319:  4279:  4269:  4261:  4221:  4211:  4203:  4164:  4125:  4115:  4107:  4067:  4059:  4009:  4001:  3966:  3958:  3919:  3909:  3901:  3838:  3828:  3820:  3781:  3773:  3734:  3724:  3716:  3647:  3637:  3629:  3588:  3580:  3541:  3495:  3485:  3477:  3438:  3428:  3420:  3378:  3368:  3360:  3295:  3285:  3277:  3238:  3230:  3170:  3160:  3152:  3113:  3103:  3095:  3053:  3043:  3035:  2972:  2964:  2925:  2915:  2907:  2858:  2848:  2840:  2747:RxList 2719:AMBOSS 2696:  2686:  2678:  2607:  2538:  2528:  2520:  2478:  2468:  2460:  2416:  2309:  2255:  2241:: 20. 2209:  2150:  2142:  2090:RxList 1991:  1981:  1973:  1932:  1924:  1885:  1875:  1867:  1827:  1817:  1809:  1770:  1760:  1752:  1704:  1694:  1686:  1639:  1607:  1561:  1551:  1543:  1499:nhs.uk 1455:  1447:  1401:  1356:nhs.uk 1323:  1315:  1238:  1228:  1220:  1180:  1170:  1162:  1113:  1078:  1068:  1060:  1016:  982:  927:stroke 873:, and 853:, and 674:myosin 613:CYP3A4 54:, and 2502:Blood 923:atria 909:), a 670:actin 296:into 95:like 5061:PMID 5043:ISSN 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Index

inotropes
myocardium
cardiac glycosides
beta-adrenergic agonists
phosphodiesterase III inhibitors
Milrinone
Digoxin
perfusion
acute heart failure
cardiogenic shock
heart failure

Cardiac glycosides
digoxin
sodium-potassium pump (Na+/K+ ATPase)
cardiomyocytes
ATP
sodium-calcium (Na+/Ca2+) exchanger
Troponin C (TnC)
sliding filament mechanism
heart failure
Digoxin
Digitalis
Digitoxin
Heart failure with reduced ejection fraction
Atrial Fibrillation
Acute coronary syndrome
hypercalcemia
hypokalemia
hypomagnesemia

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