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Cardiotonic agent

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485: 3321: 888:, 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 269: 660: 96: 825: 4306:
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).
821:, 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. 140:, 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 4812:"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" 4707:"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" 4038:"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" 4305:
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.
936:(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 4622:
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).
940:. 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. 4916:
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).
533:, 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. 679:, 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 41:(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: 288:
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.
122:(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. 1670:
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).
4919:"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" 844:. 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 813:
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
61:, possess overlapping classifications due to their ability to engage multiple mechanisms of action. Their inotropic properties make cardiactonic agents critical in addressing inadequate 4250:"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" 3614:
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".
1209:"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" 852:, with hypotension and low blood flow (hypoperfusion), placing the patient at risk of multiorgan failure. In cardiogenic shock management, cardiotonic agents serve 2 functions. 518:. 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. 5034:"Global, regional, and national prevalence, incidence, mortality, and risk factors for atrial fibrillation, 1990-2017: results from the Global Burden of Disease Study 2017" 3022:
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).
129:. The accumulation of Na+ prompts its efflux from the cell, whilst concurrently allowing Ca2+ influx through this exchanger. Consequently, intracellular Ca2+ levels rise. 4625:"Inotropic therapy in patients with advanced heart failure. A clinical consensus statement from the Heart Failure Association of the European Society of Cardiology" 1436:"Cardiac arrhythmias, electrolyte abnormalities and serum cardiac glycoside concentrations in yellow oleander (Cascabela thevetia) poisoning - a prospective study" 5032:
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).
3266:"Effects of the calcium sensitizer OR-1896, a metabolite of levosimendan, on post-infarct heart failure and cardiac remodelling in diabetic Goto–Kakizaki rats" 2391: 690:, resulting in stronger contractions without excessive calcium accumulation. By reducing strain on the heart, this mechanism helps minimise the oxygen demand. 4680: 3407:"The Perioperative Use of Levosimendan as a Means of Optimizing the Surgical Outcome in Patients with Severe Heart Insufficiency Undergoing Cardiac Surgery" 4444:
Shankar, Aditi; Gurumurthy, Gayathri; Sridharan, Lakshmi; Gupta, Divya; Nicholson, William J; Jaber, Wissam A; Vallabhajosyula, Saraschandra (2022-02-07).
2667:"PDE3 inhibition with enoximone as first-line therapy for severe persistent pulmonary hypertension of the newborn during neonatal transport: a case report" 2281: 526:, which means the blood vessels widen. Vasodilation helps to reduce resistance against blood flow, allowing for better circulation throughout the body. 3464:
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).
3322:"Early Utilization of Mechanical Circulatory Support in Acute Myocardial Infarction Complicated by Cardiogenic Shock | HeartRecovery.com" 2509:"Thrombin regulates intracellular cyclic AMP concentration in human platelets through phosphorylation/activation of phosphodiesterase 3A" 1856:"Ser1928 phosphorylation by PKA stimulates the L-type Ca2+ channel CaV1.2 and vasoconstriction during acute hyperglycemia and diabetes" 5100: 900: 903:, which quantifies the volume of blood expelled from the heart's lower chambers (ventricles) with each contraction. According to the 3264:
Louhelainen, Marjut; Merasto, Saara; Finckenberg, Piet; Vahtola, Erik; Kaheinen, Petri; Levijoki, Jouko; Mervaala, Eero (May 2010).
2340: 1532:"Intermittent low‑dose digoxin may be effective and safe in patients with chronic heart failure undergoing maintenance hemodialysis" 1505: 4892: 1913:"Phosphorylation of skeletal muscle calsequestrin enhances its Ca2+ binding capacity and promotes its association with junctin" 1673:"Cross-communication between Gi and Gs in a G-protein-coupled receptor heterotetramer guided by a receptor C-terminal domain" 904: 508: 500: 308: 3345:
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).
2367: 848:, detrimental heart structure remodelling, and even mortality. Heart failure can manifest in its life-threatening form of 1911:
Beard, Nicole A.; Wei, Lan; Cheung, Stephanie N.; Kimura, Takashi; Varsányi, Magdolna; Dulhunty, Angela F. (2008-10-01).
2392:"Increased Venous Return - Circulatory Effects - Physiological Effects Of Massage - Massage - Treatments - Physio.co.uk" 268: 3945:
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.
334:, which is a compartment within cells that acts as the Ca2+ storage site. Phosphorylation results in the activation of 2827:"Pathophysiology of visual disorders induced by phosphodiesterase inhibitors in the treatment of erectile dysfunction" 2777: 586: 416: 50: 833: 296: 659: 111: 5095: 2998: 893: 3466:"Levosimendan as rescue therapy in low output syndrome after cardiac surgery: effects and predictors of outcome" 2886:"The role of cilostazol, a phosphodiesterase 3 inhibitor, on oocyte maturation and subsequent pregnancy in mice" 1434:
D, Anandhi; Pandit, Vinay R.; Kadhiravan, Tamilarasu; R, Soundaravally; Prakash Raju, K. N. J. (February 2019).
311:. Thus, beta-agonists will lead to elevated cAMP levels, which further activate a cAMP-dependent protein called 95: 4365:"Inotropes in Acute Heart Failure: From Guidelines to Practical Use: Therapeutic Options and Clinical Practice" 126: 2884:
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
3569:"Levosimendan: A calcium-sensitizing agent for the treatment of patients with decompensated heart failure" 754: 580: 421: 331: 320: 304: 119: 1401: 1105: 982: 668:
electrical signals that trigger the release of calcium ions. These calcium ions bind to a protein called
889: 782: 448: 303:, activation of Gs proteins ultimately activates adenylyl cyclase, which is responsible for converting 2026: 1912: 2897: 2753: 1744: 1303: 917: 239: 3761: 248:
Breastfeeding: amount found in breast milk is insignificant, harm caused to foetus not well studied
2725: 2569: 929: 792: 504: 496: 191: 3024:"The calcium sensitizer drug MCI-154 binds the structural C-terminal domain of cardiac troponin C" 3890:"Levosimendan Improves Clinical Outcomes of Refractory Heart Failure in Elderly Chinese Patients" 335: 1362: 912:
patients who remain symptomatic despite receiving treatment with a first-line combination of an
4096:"Why has positive inotropy failed in chronic heart failure? Lessons from prior inotrope trials" 2184: 5071: 5053: 5014: 4996: 4956: 4938: 4849: 4841: 4791: 4783: 4744: 4736: 4662: 4654: 4604: 4586: 4545: 4527: 4483: 4465: 4421: 4394: 4345: 4327: 4287: 4269: 4229: 4211: 4172: 4133: 4115: 4075: 4067: 4017: 4009: 3974: 3966: 3927: 3909: 3846: 3828: 3789: 3781: 3742: 3724: 3655: 3637: 3596: 3588: 3549: 3503: 3485: 3446: 3428: 3386: 3368: 3303: 3285: 3246: 3238: 3178: 3160: 3121: 3103: 3061: 3043: 2980: 2972: 2933: 2915: 2866: 2848: 2704: 2686: 2615: 2546: 2528: 2486: 2468: 2424: 2317: 2263: 2217: 2158: 2150: 1999: 1981: 1940: 1932: 1893: 1875: 1835: 1817: 1778: 1760: 1712: 1694: 1647: 1615: 1569: 1551: 1463: 1455: 1409: 1331: 1323: 1246: 1228: 1188: 1170: 1121: 1086: 1068: 1024: 990: 849: 814: 749: 694: 462: 403: 103: 70: 42: 5061: 5045: 5004: 4988: 4946: 4930: 4831: 4823: 4775: 4726: 4718: 4644: 4636: 4594: 4576: 4535: 4517: 4473: 4457: 4384: 4376: 4335: 4319: 4277: 4261: 4219: 4203: 4164: 4123: 4107: 4057: 4049: 4001: 3958: 3917: 3901: 3836: 3820: 3773: 3732: 3714: 3682: 3645: 3627: 3580: 3541: 3529: 3493: 3477: 3436: 3418: 3376: 3358: 3293: 3277: 3168: 3152: 3111: 3095: 3051: 3035: 2964: 2923: 2905: 2856: 2838: 2694: 2678: 2536: 2520: 2476: 2460: 2253: 2142: 1989: 1971: 1960:"The Sarcoplasmic Reticulum of Skeletal Muscle Cells: A Labyrinth of Membrane Contact Sites" 1924: 1883: 1867: 1825: 1809: 1768: 1752: 1702: 1684: 1559: 1543: 1447: 1315: 1236: 1220: 1178: 1162: 1149:
Eisner, David A.; Caldwell, Jessica L.; Kistamás, Kornél; Trafford, Andrew W. (2017-07-07).
1113: 1076: 1060: 687: 515: 312: 300: 292: 1733:"Evidence for functional pre-coupled complexes of receptor heteromers and adenylyl cyclase" 77:. These conditions arise when the heart's ability to meet the body's needs is compromised. 4763: 453: 315:. PK-A plays a pivotal role in increasing intracellular Ca2+ levels through 2 mechanisms: 3530:"Unusual Excessive Swelling of the Tongue after Calcium Acetate Ingestion: A Case Report" 872:(vasoconstrictive) functions to constrict blood vessels to correct hypotension. Whereas, 4951: 4918: 4811: 4706: 4624: 4540: 4505: 4037: 3441: 3406: 2901: 1748: 272:
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+
5089: 4867: 3686: 3281: 2968: 2464: 1798:"Cross-talk between calcium and protein kinase A in the regulation of cell migration" 913: 865: 744: 576: 393: 187: 141: 74: 66: 53:, and calcium sensitizers. It is important to note that certain medications, such as 957: 4446:"A Clinical Update on Vasoactive Medication in the Management of Cardiogenic Shock" 2096: 921: 885: 771: 729: 698: 523: 439: 3824: 3156: 1451: 1166: 99:
Mechanism of action of cardiac glycosides (Digitalis): inhibition of Na+/K+ ATPase
17: 4934: 4764:"The Effect of Digoxin on Mortality and Morbidity in Patients with Heart Failure" 3992:
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).
932:- a heart rhythm disorder characterised by irregular electrical impulses in the 869: 801:
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
4976: 3423: 2843: 2242:"Current use and advances in vasopressors and inotropes support in shock" 2185:"Adrenergic Agonists (Sympathomimetics) Nursing Pharmacology Study Guide" 1976: 1302:
Gheorghiade, Mihai; Adams, Kirkwood F.; Colucci, Wilson S. (2004-06-22).
1064: 958:"Cases | Pharmacotherapy Principles & Practice | McGraw Hill Medical" 861: 669: 530: 383: 342:(the universal fluid that bathes the different compartments inside cells) 34: 4581: 3905: 3632: 3616:"Use of Levosimendan in Patients with Advanced Heart Failure: An Update" 2061: 701:
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
172: 107: 58: 4827: 4722: 4649: 4640: 4111: 4053: 4005: 2282:"Phosphodiesterase III Inhibitor - an overview | ScienceDirect Topics" 2208:
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)
684: 640: 623: 299:. Due to the coupling nature between β1, Gs proteins, and the enzyme 4168: 3993: 488:
Mechanism of action of PDE III inhibitors: inhibition of PDE3 enzyme
3347:"Arterial pulmonary hypertension in noncardiac intensive care unit" 2951:
Lehmann, Andreas; Boldt, Joachim; Kirchner, Jürgen (October 2003).
1015:
Pirahanchi, Yasaman; Jessu, Rishita; Aeddula, Narothama R. (2024),
4977:"US Health Care Spending by Payer and Health Condition, 1996-2016" 3994:"Use of Inotropic Agents in Advanced Heart Failure: Pros and Cons" 3865:"Drug-induced QT prolongation and Torsades de Pointes - the facts" 2368:"Phosphodiesterase Inhibitor - an overview | ScienceDirect Topics" 680: 251:
Renally impaired: consider reducing initial and maintenance doses
2953:"The role of Ca++-sensitizers for the treatment of heart failure" 499:. This enzyme is responsible for breaking down a molecule called 495:
exert their effects by blocking the activity of an enzyme called
5038:
European Heart Journal - Quality of Care & Clinical Outcomes
2754:"How Do PDE-3 Inhibitors Work? - Uses, Side Effects, Drug Names" 1104:
Ohtsuki, Iwao; Morimoto, Sachio; Kitainda, Vivian (2021-01-01),
511:
is prevented, leading to increased levels of cAMP in our cells.
4565:"Inotropes do not increase mortality in advanced heart failure" 3809:"Acquired long QT syndrome in chronic kidney disease patients" 2097:"Dopamine: Side Effects, Uses, Dosage, Interactions, Warnings" 1506:"Pregnancy, breastfeeding and fertility while taking digoxin" 828:
Cardiogenic shock leads to many harmful physiological effects
799:
Compelling indication in elderly patients with heart failure
529:
Furthermore, PDE3 inhibitors exhibit an additional effect on
4412:
Kosaraju, Ateet; Pendela, Venkata Satish; Hai, Ofek (2024),
4192:"Role of Inotropic Agents in the Treatment of Heart Failure" 3947:"A systematic review on levosimendan in paediatric patients" 1606:
Farzam, Khashayar; Kidron, Ariel; Lakhkar, Anand D. (2024),
1049:"The Cardiac Na+-Ca2+ Exchanger: From Structure to Function" 1151:"Calcium and Excitation-Contraction Coupling in the Heart" 4190:
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2999:"Calcium Sensitizer - an overview | ScienceDirect Topics" 503:, which is the key signalling molecule in our body. When 1110:
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3703:"Electrolyte Disorders Induced by Antineoplastic Drugs" 3227:"[Clinical significance of calcium sensitizer]" 2341:"Protein Kinase A - an overview | ScienceDirect Topics" 1304:"Digoxin in the Management of Cardiovascular Disorders" 639:, a specific form of cell division that takes place in 1406:
Saunders Handbook of Veterinary Drugs (Fourth Edition)
643:, which are specialized reproductive cells in females 246:
Pregnancy: can be used, may require dosage adjustment
4506:"Management of cardiogenic shock: a narrative review" 2802:"PDE3 Inhibitor - an overview | ScienceDirect Topics" 2570:"PDE3 Inhibitor - an overview | ScienceDirect Topics" 2449:"Anti-platelet therapy: phosphodiesterase inhibitors" 1400:
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
672:, which initiates the process of muscle contraction. 136:
is significant, as it prepares muscle fibres for the
3082:
Kuo, Ivana Y.; Ehrlich, Barbara E. (February 2015).
2362: 2360: 1482:"Cardiovascular Disease Medication During Pregnancy" 295:
are a subunit of a large family of receptors called
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Saunders, pp. 241–242, 227:(blood flow to heart muscle suddenly blocked) 4681:"Ejection Fraction Heart Failure Measurement" 3470:The Journal of International Medical Research 989:, Waltham: Academic Press, pp. 681–687, 618:Psychological disorder (for example anxiety) 37:or stimulants, have a positive impact on the 8: 4762:Digitalis Investigation Group (1997-02-20). 4151:Bistola, V.; Chioncel, O. (September 2017). 2507:Zhang, Wei; Colman, Robert W. (2007-09-01). 1638:Alhayek, Soubhi; Preuss, Charles V. (2024), 1144: 1142: 747:(but no significant reduction in mortality) 188:Heart failure with reduced ejection fraction 4893:"Atrial fibrillation - Symptoms and causes" 981:Haviv, H.; Karlish, S. J. D. (2013-01-01), 926:mineralocorticoid receptor antagonist (MRA) 606:(heart rate too fast) Rapid drop in Weight 424:(malfunction in heart's electrical system) 4563:Guglin, Maya; Kaufman, Marc (2014-05-20). 3088:Cold Spring Harbor Perspectives in Biology 2606:Padda, Inderbir S.; Tripp, Jayson (2024), 2308:Padda, Inderbir S.; Tripp, Jayson (2024), 2135:Journal of Allergy and Clinical Immunology 5065: 5008: 4950: 4835: 4730: 4648: 4598: 4580: 4569:International Journal of General Medicine 4539: 4521: 4477: 4388: 4339: 4281: 4223: 4127: 4061: 3921: 3840: 3736: 3718: 3649: 3631: 3497: 3440: 3422: 3380: 3362: 3297: 3172: 3115: 3055: 2927: 2909: 2860: 2842: 2698: 2540: 2480: 2257: 1993: 1975: 1887: 1829: 1772: 1706: 1688: 1563: 1240: 1182: 1080: 928:. It is also considered in patients with 330:Phosphorylation at specific sites on the 73:, as well as for long-term management of 2453:British Journal of Clinical Pharmacology 823: 708: 697:in the heart muscle cells, resulting in 658: 540: 483: 353: 267: 151: 94: 2415:Ramanlal, Riddhi; Gupta, Vikas (2024), 2183:RN, Iris Dawn Tabangcora (2017-07-11). 949: 4499: 4497: 4450:Clinical Medicine Insights. Cardiology 3523: 3521: 3519: 3517: 3202:"Cardiotonic Agents | DrugBank Online" 3196: 3194: 3192: 3077: 3075: 2748: 2746: 2720: 2718: 2660: 2658: 2601: 2599: 2597: 2595: 2593: 2591: 2589: 2564: 2562: 2560: 2502: 2500: 2303: 2301: 2178: 2176: 2174: 2172: 1112:, Oxford: Elsevier, pp. 695–700, 896:(medical device to assist the heart). 3675:Clinical and Experimental Dermatology 2124: 2122: 2120: 2118: 2116: 2091: 2089: 2087: 2085: 2083: 2081: 2056: 2054: 2052: 2050: 2048: 2046: 2021: 2019: 2017: 2015: 2013: 1601: 1599: 1597: 1595: 1593: 1591: 1589: 1587: 1585: 1583: 1536:Experimental and Therapeutic Medicine 1395: 1393: 1391: 1389: 1387: 1385: 1383: 1357: 1355: 1353: 1351: 1349: 1347: 1345: 595:Chronic Obstructive Pulmonary Disease 475:3) Phosphodiesterase (III) inhibitors 112:sodium-potassium pump (Na+/K+ ATPase) 7: 2831:Drug Design, Development and Therapy 1297: 1295: 1293: 1291: 1289: 1264: 1262: 1260: 905:European Society of Cardiology (ESC) 795:(abnormal repolarize time of heart) 3351:Vascular Health and Risk Management 3028:Biochemistry and Biophysics Reports 2129:Sears, Malcolm R. (December 2002). 1017:"Physiology, Sodium Potassium Pump" 817:(lower chambers of the heart), low 297:G-protein-coupled receptors (GPCRs) 127:sodium-calcium (Na+/Ca2+) exchanger 4153:"Inotropes in acute heart failure" 1320:10.1161/01.CIR.0000132482.95686.87 1118:10.1016/b978-0-12-819460-7.00204-8 901:left ventricular ejection fraction 25: 4816:European Journal of Heart Failure 4711:European Journal of Heart Failure 4629:European Journal of Heart Failure 4208:10.1161/CIRCULATIONAHA.109.899294 4100:European Journal of Heart Failure 4042:European Journal of Heart Failure 3963:10.2174/1570161112666141127163536 3778:10.1161/CIRCULATIONAHA.105.542407 3084:"Signaling in Muscle Contraction" 1213:European Journal of Heart Failure 1106:"Structural Proteins | Troponin☆" 132:The interaction between Ca2+ and 3687:10.1046/j.1365-2230.2003.01141.x 3282:10.1111/j.1476-5381.2010.00680.x 2969:10.1097/00075198-200310000-00002 2957:Current Opinion in Critical Care 2465:10.1111/j.1365-2125.2011.04034.x 868:contribute mainly through their 456:(clogging of blood vessel wall) 51:phosphodiesterase III inhibitors 4768:New England Journal of Medicine 4308:"Treatments targeting inotropy" 4157:Continuing Cardiology Education 3270:British Journal of Pharmacology 2131:"Adverse effects of β-agonists" 1802:Current Opinion in Cell Biology 894:left ventricular assist devices 507:is inhibited, the breakdown of 3567:Lehtonen, Lasse (2004-09-01). 3534:Eurasian Journal of Toxicology 3225:Sakata, Yasushi (April 2013). 2726:"Phosphodiesterase inhibitors" 2608:"Phosphodiesterase Inhibitors" 2310:"Phosphodiesterase Inhibitors" 1796:Howe, Alan K. (October 2011). 1486:American College of Cardiology 809:Clinical role in heart failure 118:(cardiac muscle cells). Using 1: 3951:Current Vascular Pharmacology 3825:10.1080/0886022X.2019.1707098 3573:Current Heart Failure Reports 3157:10.1080/19336950.2015.1076597 1452:10.1080/15563650.2018.1499930 1167:10.1161/CIRCRESAHA.117.310230 983:"P-Type Pumps: Na+,K+-ATPase" 780:Renal and hepatic impairment 219:Impaired renal function 4935:10.1161/CIR.0000000000001193 3620:Journal of Clinical Medicine 2911:10.1371/journal.pone.0030649 2525:10.1182/blood-2006-10-052522 2210:"Inotropes and Vasopressors" 907:, among cardiotonic agents, 601:Gastrointestinal discomfort 276:Naturally produced hormones 4780:10.1056/NEJM199702203360801 4266:10.1136/bmjopen-2021-053254 3100:10.1101/cshperspect.a006023 3040:10.1016/j.bbrep.2018.10.012 587:Peripheral Vascular Disease 449:Acute myocardial infarction 417:Decompensated heart failure 332:sarcoplasmic reticulum (SR) 284:or synthetic drugs such as 259:2) Beta-adrenergic agonists 5117: 4523:10.1186/s13613-024-01260-y 2417:"Physiology, Vasodilation" 2027:"Beta-agonist Medications" 1929:10.1016/j.ceca.2008.01.005 1757:10.1038/s41467-018-03522-3 776:Injection site irritation 336:ryanodine receptors (RyRs) 138:sliding filament mechanism 5101:Cardiovascular physiology 4462:10.1177/11795468221075064 3585:10.1007/s11897-004-0023-6 2259:10.21037/jeccm.2019.12.03 1872:10.1126/scisignal.aaf9647 1814:10.1016/j.ceb.2011.05.006 1690:10.1186/s12915-018-0491-x 1363:"Side effects of digoxin" 763:Isolated tongue swelling 27:Class of heart medication 4510:Annals of Intensive Care 4324:10.1093/eurheartj/ehy600 3482:10.1177/0300060519835087 1108:, in Jez, Joseph (ed.), 1053:Comprehensive Physiology 836:, recommends the use of 431:(abnormal heart rhythm) 194:(abnormal heart rhythm) 110:, primarily inhibit the 47:beta-adrenergic agonists 33:, also known as cardiac 5050:10.1093/ehjqcco/qcaa061 3894:Medical Science Monitor 3720:10.3389/fonc.2020.00779 2147:10.1067/mai.2002.129966 705:Pharmacotherapy profile 537:Pharmacotherapy profile 350:Pharmacotherapy profile 313:protein-kinase A (PK-A) 230:Electrolyte disorders ( 225:Acute coronary syndrome 148:Pharmacotherapy profile 4993:10.1001/jama.2020.0734 4381:10.15420/cfr.2019.11.2 4369:Cardiac Failure Review 4312:European Heart Journal 3546:10.51262/ejtox.1236194 3141:"Cardiac ion channels" 829: 787:Patients with prolong 755:Pulmonary Hypertension 664: 650:4) Calcium sensitisers 581:Pulmonary Hypertension 516:protein kinase A (PKA) 489: 422:Atrioventricular block 273: 100: 4868:"Atrial fibrillation" 4456:: 11795468221075064. 3707:Frontiers in Oncology 3326:www.heartrecovery.com 3003:www.sciencedirect.com 2806:www.sciencedirect.com 2671:Clinical Case Reports 2574:www.sciencedirect.com 2372:www.sciencedirect.com 2345:www.sciencedirect.com 2286:www.sciencedirect.com 1737:Nature Communications 1548:10.3892/etm.2014.2013 827: 783:Electrolyte imbalance 759:Post-Cardiac Surgery 662: 487: 271: 98: 86:1) Cardiac Glycosides 69:conditions including 3424:10.3390/jcdd10080332 2844:10.2147/DDDT.S118015 1977:10.3390/biom12040488 1155:Circulation Research 1065:10.1002/cphy.c200031 724:Special populations 718:Common side effects 556:Special populations 550:Common side effects 369:Special populations 363:Common side effects 360:General Indications 321:L-type Ca2+ channels 167:Special populations 161:Common side effects 158:General indications 4582:10.2147/IJGM.S62549 4414:"Cardiogenic Shock" 3906:10.12659/MSM.893580 3869:www.medsafe.govt.nz 3633:10.3390/jcm11216408 2902:2012PLoSO...730649L 1749:2018NatCo...9.1242N 1440:Clinical Toxicology 930:atrial fibrillation 655:Mechanism of action 480:Mechanism of action 413:Severe hypotension 319:Phosphorylation of 264:Mechanism of action 192:Atrial Fibrillation 91:Mechanism of action 67:acute heart failure 3364:10.2147/vhrm.s3998 1640:"Beta 1 Receptors" 1608:"Adrenergic Drugs" 830: 695:potassium channels 665: 490: 400:Anaphylactic shock 274: 221:Thyroid disorders 104:Cardiac glycosides 101: 43:cardiac glycosides 31:Cardiotonic agents 18:Cardiotonic agents 4828:10.1002/ejhf.2333 4723:10.1002/ejhf.2333 4641:10.1002/ejhf.2814 4318:(44): 3626–3644. 4202:(14): 1655–1660. 4112:10.1002/ejhf.1557 4054:10.1002/ejhf.2333 4006:10.1159/000536373 1866:(463): eaaf9647. 1860:Science Signaling 1415:978-0-323-24485-5 1314:(24): 2959–2964. 1225:10.1002/ejhf.1452 1127:978-0-12-822040-5 996:978-0-12-378631-9 962:ppp.mhmedical.com 850:cardiogenic shock 806: 805: 750:Cardiogenic Shock 647: 646: 472: 471: 463:Diabetes mellitus 404:Cardiogenic shock 256: 255: 209:Vision disorders 71:cardiogenic shock 16:(Redirected from 5108: 5096:Inotropic agents 5080: 5079: 5069: 5029: 5023: 5022: 5012: 4971: 4965: 4964: 4954: 4913: 4907: 4906: 4904: 4903: 4889: 4883: 4882: 4880: 4879: 4864: 4858: 4857: 4839: 4806: 4800: 4799: 4759: 4753: 4752: 4734: 4701: 4695: 4694: 4692: 4691: 4677: 4671: 4670: 4652: 4619: 4613: 4612: 4602: 4584: 4560: 4554: 4553: 4543: 4525: 4501: 4492: 4491: 4481: 4441: 4435: 4434: 4433: 4432: 4409: 4403: 4402: 4392: 4360: 4354: 4353: 4343: 4302: 4296: 4295: 4285: 4244: 4238: 4237: 4227: 4187: 4181: 4180: 4148: 4142: 4141: 4131: 4106:(9): 1064–1078. 4090: 4084: 4083: 4065: 4032: 4026: 4025: 3989: 3983: 3982: 3942: 3936: 3935: 3925: 3885: 3879: 3878: 3876: 3875: 3861: 3855: 3854: 3844: 3804: 3798: 3797: 3757: 3751: 3750: 3740: 3722: 3697: 3691: 3690: 3670: 3664: 3663: 3653: 3635: 3611: 3605: 3604: 3564: 3558: 3557: 3525: 3512: 3511: 3501: 3476:(8): 3502–3512. 3461: 3455: 3454: 3444: 3426: 3401: 3395: 3394: 3384: 3366: 3357:(5): 1043–1060. 3342: 3336: 3335: 3333: 3332: 3318: 3312: 3311: 3301: 3261: 3255: 3254: 3231:Clinical Calcium 3222: 3216: 3215: 3213: 3212: 3198: 3187: 3186: 3176: 3136: 3130: 3129: 3119: 3079: 3070: 3069: 3059: 3019: 3013: 3012: 3010: 3009: 2995: 2989: 2988: 2948: 2942: 2941: 2931: 2913: 2881: 2875: 2874: 2864: 2846: 2822: 2816: 2815: 2813: 2812: 2798: 2792: 2791: 2789: 2788: 2782:Cleveland Clinic 2774: 2768: 2767: 2765: 2764: 2750: 2741: 2740: 2738: 2737: 2722: 2713: 2712: 2702: 2683:10.1002/ccr3.748 2662: 2653: 2652: 2650: 2649: 2635: 2629: 2628: 2627: 2626: 2603: 2584: 2583: 2581: 2580: 2566: 2555: 2554: 2544: 2519:(5): 1475–1482. 2504: 2495: 2494: 2484: 2444: 2438: 2437: 2436: 2435: 2412: 2406: 2405: 2403: 2402: 2396:www.physio.co.uk 2388: 2382: 2381: 2379: 2378: 2364: 2355: 2354: 2352: 2351: 2337: 2331: 2330: 2329: 2328: 2305: 2296: 2295: 2293: 2292: 2278: 2272: 2271: 2261: 2237: 2231: 2230: 2229: 2228: 2205: 2199: 2198: 2196: 2195: 2180: 2167: 2166: 2141:(6): S322–S328. 2126: 2111: 2110: 2108: 2107: 2093: 2076: 2075: 2073: 2072: 2058: 2041: 2040: 2038: 2037: 2031:Cleveland Clinic 2023: 2008: 2007: 1997: 1979: 1955: 1949: 1948: 1908: 1902: 1901: 1891: 1850: 1844: 1843: 1833: 1793: 1787: 1786: 1776: 1727: 1721: 1720: 1710: 1692: 1667: 1661: 1660: 1659: 1658: 1635: 1629: 1628: 1627: 1626: 1603: 1578: 1577: 1567: 1542:(6): 1689–1694. 1527: 1521: 1520: 1518: 1517: 1502: 1496: 1495: 1493: 1492: 1478: 1472: 1471: 1431: 1425: 1424: 1423: 1422: 1397: 1378: 1377: 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2114: 2105: 2103: 2095: 2094: 2079: 2070: 2068: 2066:go.drugbank.com 2060: 2059: 2044: 2035: 2033: 2025: 2024: 2011: 1957: 1956: 1952: 1910: 1909: 1905: 1852: 1851: 1847: 1795: 1794: 1790: 1729: 1728: 1724: 1669: 1668: 1664: 1656: 1654: 1637: 1636: 1632: 1624: 1622: 1605: 1604: 1581: 1529: 1528: 1524: 1515: 1513: 1504: 1503: 1499: 1490: 1488: 1480: 1479: 1475: 1433: 1432: 1428: 1420: 1418: 1416: 1399: 1398: 1381: 1372: 1370: 1361: 1360: 1343: 1301: 1300: 1287: 1278: 1276: 1268: 1267: 1258: 1205: 1204: 1200: 1148: 1147: 1140: 1132: 1130: 1128: 1103: 1102: 1098: 1046: 1045: 1041: 1033: 1031: 1014: 1013: 1009: 1001: 999: 997: 980: 979: 975: 966: 964: 956: 955: 951: 946: 815:left ventricles 811: 707: 657: 652: 597:(lung disease) 539: 493:PDE3 inhibitors 482: 477: 454:Atherosclerosis 451:(heart attack) 352: 266: 261: 150: 93: 88: 83: 28: 23: 22: 15: 12: 11: 5: 5114: 5112: 5104: 5103: 5098: 5088: 5087: 5082: 5081: 5044:(6): 574–582. 5024: 4987:(9): 863–884. 4966: 4929:(1): e1–e156. 4908: 4884: 4859: 4801: 4774:(8): 525–533. 4754: 4696: 4672: 4635:(4): 457–468. 4614: 4555: 4493: 4436: 4404: 4375:(3): 133–139. 4355: 4297: 4260:(1): e053254. 4239: 4182: 4163:(3): 107–116. 4143: 4085: 4027: 3984: 3957:(1): 128–133. 3937: 3880: 3856: 3799: 3772:(2): 305–315. 3752: 3692: 3665: 3606: 3579:(3): 136–144. 3559: 3513: 3456: 3396: 3337: 3313: 3276:(1): 142–152. 3256: 3237:(4): 575–582. 3217: 3188: 3151:(6): 352–359. 3131: 3094:(2): a006023. 3071: 3014: 2990: 2963:(5): 337–344. 2943: 2876: 2817: 2793: 2769: 2742: 2714: 2654: 2630: 2585: 2556: 2496: 2459:(4): 634–646. 2439: 2407: 2383: 2356: 2332: 2297: 2273: 2232: 2200: 2168: 2112: 2077: 2042: 2009: 1950: 1923:(4): 363–373. 1903: 1854:(2017-01-24). 1845: 1808:(5): 554–561. 1788: 1722: 1662: 1630: 1579: 1522: 1497: 1473: 1446:(2): 104–111. 1426: 1414: 1379: 1341: 1285: 1256: 1219:(5): 676–684. 1198: 1161:(2): 181–195. 1138: 1126: 1096: 1039: 1007: 995: 973: 948: 947: 945: 942: 854:Norepinephrine 819:cardiac output 810: 807: 804: 803: 797: 778: 761: 742: 726: 725: 722: 719: 716: 713: 712:Drug examples 706: 703: 656: 653: 651: 648: 645: 644: 633: 629:ophthalmopathy 620: 599: 574: 558: 557: 554: 551: 548: 545: 544:Drug examples 538: 535: 481: 478: 476: 473: 470: 469: 466: 446: 426: 409:Cardiac arrest 397: 379:Norepinephrine 371: 370: 367: 364: 361: 358: 357:Drug examples 351: 348: 344: 343: 328: 278:norepinephrine 265: 262: 260: 257: 254: 253: 244: 240:hypomagnesemia 217: 196: 185: 169: 168: 165: 162: 159: 156: 155:Drug examples 149: 146: 116:cardiomyocytes 92: 89: 87: 84: 82: 81:Classification 79: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 5113: 5102: 5099: 5097: 5094: 5093: 5091: 5077: 5073: 5068: 5063: 5059: 5055: 5051: 5047: 5043: 5039: 5035: 5028: 5025: 5020: 5016: 5011: 5006: 5002: 4998: 4994: 4990: 4986: 4982: 4978: 4970: 4967: 4962: 4958: 4953: 4948: 4944: 4940: 4936: 4932: 4928: 4924: 4920: 4912: 4909: 4898: 4894: 4888: 4885: 4873: 4869: 4863: 4860: 4855: 4851: 4847: 4843: 4838: 4833: 4829: 4825: 4821: 4817: 4813: 4805: 4802: 4797: 4793: 4789: 4785: 4781: 4777: 4773: 4769: 4765: 4758: 4755: 4750: 4746: 4742: 4738: 4733: 4728: 4724: 4720: 4716: 4712: 4708: 4700: 4697: 4686: 4685:www.heart.org 4682: 4676: 4673: 4668: 4664: 4660: 4656: 4651: 4646: 4642: 4638: 4634: 4630: 4626: 4618: 4615: 4610: 4606: 4601: 4596: 4592: 4588: 4583: 4578: 4574: 4570: 4566: 4559: 4556: 4551: 4547: 4542: 4537: 4533: 4529: 4524: 4519: 4515: 4511: 4507: 4500: 4498: 4494: 4489: 4485: 4480: 4475: 4471: 4467: 4463: 4459: 4455: 4451: 4447: 4440: 4437: 4427: 4423: 4419: 4415: 4408: 4405: 4400: 4396: 4391: 4386: 4382: 4378: 4374: 4370: 4366: 4359: 4356: 4351: 4347: 4342: 4337: 4333: 4329: 4325: 4321: 4317: 4313: 4309: 4301: 4298: 4293: 4289: 4284: 4279: 4275: 4271: 4267: 4263: 4259: 4255: 4251: 4243: 4240: 4235: 4231: 4226: 4221: 4217: 4213: 4209: 4205: 4201: 4197: 4193: 4186: 4183: 4178: 4174: 4170: 4166: 4162: 4158: 4154: 4147: 4144: 4139: 4135: 4130: 4125: 4121: 4117: 4113: 4109: 4105: 4101: 4097: 4089: 4086: 4081: 4077: 4073: 4069: 4064: 4059: 4055: 4051: 4047: 4043: 4039: 4031: 4028: 4023: 4019: 4015: 4011: 4007: 4003: 3999: 3995: 3988: 3985: 3980: 3976: 3972: 3968: 3964: 3960: 3956: 3952: 3948: 3941: 3938: 3933: 3929: 3924: 3919: 3915: 3911: 3907: 3903: 3900:: 2439–2445. 3899: 3895: 3891: 3884: 3881: 3870: 3866: 3860: 3857: 3852: 3848: 3843: 3838: 3834: 3830: 3826: 3822: 3818: 3814: 3813:Renal Failure 3810: 3803: 3800: 3795: 3791: 3787: 3783: 3779: 3775: 3771: 3767: 3763: 3756: 3753: 3748: 3744: 3739: 3734: 3730: 3726: 3721: 3716: 3712: 3708: 3704: 3696: 3693: 3688: 3684: 3680: 3676: 3669: 3666: 3661: 3657: 3652: 3647: 3643: 3639: 3634: 3629: 3625: 3621: 3617: 3610: 3607: 3602: 3598: 3594: 3590: 3586: 3582: 3578: 3574: 3570: 3563: 3560: 3555: 3551: 3547: 3543: 3539: 3535: 3531: 3524: 3522: 3520: 3518: 3514: 3509: 3505: 3500: 3495: 3491: 3487: 3483: 3479: 3475: 3471: 3467: 3460: 3457: 3452: 3448: 3443: 3438: 3434: 3430: 3425: 3420: 3416: 3412: 3408: 3400: 3397: 3392: 3388: 3383: 3378: 3374: 3370: 3365: 3360: 3356: 3352: 3348: 3341: 3338: 3327: 3323: 3317: 3314: 3309: 3305: 3300: 3295: 3291: 3287: 3283: 3279: 3275: 3271: 3267: 3260: 3257: 3252: 3248: 3244: 3240: 3236: 3232: 3228: 3221: 3218: 3207: 3203: 3197: 3195: 3193: 3189: 3184: 3180: 3175: 3170: 3166: 3162: 3158: 3154: 3150: 3146: 3142: 3135: 3132: 3127: 3123: 3118: 3113: 3109: 3105: 3101: 3097: 3093: 3089: 3085: 3078: 3076: 3072: 3067: 3063: 3058: 3053: 3049: 3045: 3041: 3037: 3033: 3029: 3025: 3018: 3015: 3004: 3000: 2994: 2991: 2986: 2982: 2978: 2974: 2970: 2966: 2962: 2958: 2954: 2947: 2944: 2939: 2935: 2930: 2925: 2921: 2917: 2912: 2907: 2903: 2899: 2896:(1): e30649. 2895: 2891: 2887: 2880: 2877: 2872: 2868: 2863: 2858: 2854: 2850: 2845: 2840: 2837:: 3407–3413. 2836: 2832: 2828: 2821: 2818: 2807: 2803: 2797: 2794: 2783: 2779: 2773: 2770: 2759: 2755: 2749: 2747: 2743: 2731: 2727: 2721: 2719: 2715: 2710: 2706: 2701: 2696: 2692: 2688: 2684: 2680: 2676: 2672: 2668: 2661: 2659: 2655: 2644: 2640: 2634: 2631: 2621: 2617: 2613: 2609: 2602: 2600: 2598: 2596: 2594: 2592: 2590: 2586: 2575: 2571: 2565: 2563: 2561: 2557: 2552: 2548: 2543: 2538: 2534: 2530: 2526: 2522: 2518: 2514: 2510: 2503: 2501: 2497: 2492: 2488: 2483: 2478: 2474: 2470: 2466: 2462: 2458: 2454: 2450: 2443: 2440: 2430: 2426: 2422: 2418: 2411: 2408: 2397: 2393: 2387: 2384: 2373: 2369: 2363: 2361: 2357: 2346: 2342: 2336: 2333: 2323: 2319: 2315: 2311: 2304: 2302: 2298: 2287: 2283: 2277: 2274: 2269: 2265: 2260: 2255: 2251: 2247: 2243: 2236: 2233: 2223: 2219: 2215: 2211: 2204: 2201: 2190: 2186: 2179: 2177: 2175: 2173: 2169: 2164: 2160: 2156: 2152: 2148: 2144: 2140: 2136: 2132: 2125: 2123: 2121: 2119: 2117: 2113: 2102: 2098: 2092: 2090: 2088: 2086: 2084: 2082: 2078: 2067: 2063: 2057: 2055: 2053: 2051: 2049: 2047: 2043: 2032: 2028: 2022: 2020: 2018: 2016: 2014: 2010: 2005: 2001: 1996: 1991: 1987: 1983: 1978: 1973: 1969: 1965: 1961: 1954: 1951: 1946: 1942: 1938: 1934: 1930: 1926: 1922: 1918: 1914: 1907: 1904: 1899: 1895: 1890: 1885: 1881: 1877: 1873: 1869: 1865: 1861: 1857: 1849: 1846: 1841: 1837: 1832: 1827: 1823: 1819: 1815: 1811: 1807: 1803: 1799: 1792: 1789: 1784: 1780: 1775: 1770: 1766: 1762: 1758: 1754: 1750: 1746: 1742: 1738: 1734: 1726: 1723: 1718: 1714: 1709: 1704: 1700: 1696: 1691: 1686: 1682: 1678: 1674: 1666: 1663: 1653: 1649: 1645: 1641: 1634: 1631: 1621: 1617: 1613: 1609: 1602: 1600: 1598: 1596: 1594: 1592: 1590: 1588: 1586: 1584: 1580: 1575: 1571: 1566: 1561: 1557: 1553: 1549: 1545: 1541: 1537: 1533: 1526: 1523: 1511: 1507: 1501: 1498: 1487: 1483: 1477: 1474: 1469: 1465: 1461: 1457: 1453: 1449: 1445: 1441: 1437: 1430: 1427: 1417: 1411: 1407: 1403: 1396: 1394: 1392: 1390: 1388: 1386: 1384: 1380: 1368: 1364: 1358: 1356: 1354: 1352: 1350: 1348: 1346: 1342: 1337: 1333: 1329: 1325: 1321: 1317: 1313: 1309: 1305: 1298: 1296: 1294: 1292: 1290: 1286: 1275: 1271: 1265: 1263: 1261: 1257: 1252: 1248: 1243: 1238: 1234: 1230: 1226: 1222: 1218: 1214: 1210: 1202: 1199: 1194: 1190: 1185: 1180: 1176: 1172: 1168: 1164: 1160: 1156: 1152: 1145: 1143: 1139: 1129: 1123: 1119: 1115: 1111: 1107: 1100: 1097: 1092: 1088: 1083: 1078: 1074: 1070: 1066: 1062: 1058: 1054: 1050: 1043: 1040: 1030: 1026: 1022: 1018: 1011: 1008: 998: 992: 988: 984: 977: 974: 963: 959: 953: 950: 943: 941: 939: 935: 931: 927: 923: 919: 915: 914:ACE inhibitor 910: 906: 902: 897: 895: 891: 887: 883: 879: 875: 871: 867: 866:phenylephrine 863: 859: 855: 851: 847: 843: 839: 835: 826: 822: 820: 816: 808: 802: 798: 796: 794: 790: 785: 784: 779: 777: 774: 773: 769: 766: 762: 760: 757: 756: 752: 751: 746: 745:Heart failure 743: 741: 740: 736: 735: 731: 728: 727: 723: 720: 717: 714: 711: 710: 704: 702: 700: 696: 691: 689: 686: 682: 678: 673: 671: 661: 654: 649: 642: 638: 634: 632: 630: 627:Pre-existing 625: 621: 619: 616: 613: 610: 607: 605: 600: 598: 596: 592: 589: 588: 584: 582: 578: 577:Heart Failure 575: 573: 572: 568: 567: 563: 560: 559: 555: 552: 549: 546: 543: 542: 536: 534: 532: 527: 525: 519: 517: 512: 510: 506: 502: 498: 494: 486: 479: 474: 467: 465: 464: 460: 457: 455: 450: 447: 445: 442: 441: 437: 436:Hypertension 434: 430: 427: 425: 423: 419: 418: 414: 411: 410: 406: 405: 401: 398: 396: 395: 394:Isoproterenol 391: 390: 386: 385: 381: 380: 376: 373: 372: 368: 365: 362: 359: 356: 355: 349: 347: 341: 337: 333: 329: 326: 322: 318: 317: 316: 314: 310: 306: 302: 298: 294: 290: 287: 283: 279: 270: 263: 258: 252: 249: 245: 243: 241: 237: 233: 232:hypercalcemia 228: 226: 222: 218: 216: 213: 210: 207: 204: 201: 197: 195: 193: 189: 186: 184: 183: 179: 178: 174: 171: 170: 166: 163: 160: 157: 154: 153: 147: 145: 143: 142:heart failure 139: 135: 130: 128: 123: 121: 117: 113: 109: 105: 97: 90: 85: 80: 78: 76: 75:heart failure 72: 68: 64: 60: 56: 52: 48: 44: 40: 36: 32: 19: 5041: 5037: 5027: 4984: 4980: 4969: 4926: 4922: 4911: 4900:. Retrieved 4896: 4887: 4876:. Retrieved 4874:. 2017-10-20 4871: 4862: 4822:(1): 4–131. 4819: 4815: 4804: 4771: 4767: 4757: 4717:(1): 4–131. 4714: 4710: 4699: 4688:. Retrieved 4684: 4675: 4632: 4628: 4617: 4572: 4568: 4558: 4513: 4509: 4453: 4449: 4439: 4429:, retrieved 4417: 4407: 4372: 4368: 4358: 4315: 4311: 4300: 4257: 4253: 4242: 4199: 4195: 4185: 4160: 4156: 4146: 4103: 4099: 4088: 4048:(1): 4–131. 4045: 4041: 4030: 3997: 3987: 3954: 3950: 3940: 3897: 3893: 3883: 3872:. Retrieved 3868: 3859: 3819:(1): 54–65. 3816: 3812: 3802: 3769: 3765: 3755: 3710: 3706: 3695: 3681:(1): 34–36. 3678: 3674: 3668: 3626:(21): 6408. 3623: 3619: 3609: 3576: 3572: 3562: 3540:(1): 17–19. 3537: 3533: 3473: 3469: 3459: 3414: 3410: 3399: 3354: 3350: 3340: 3329:. Retrieved 3325: 3316: 3273: 3269: 3259: 3234: 3230: 3220: 3209:. Retrieved 3205: 3148: 3144: 3134: 3091: 3087: 3031: 3027: 3017: 3006:. Retrieved 3002: 2993: 2960: 2956: 2946: 2893: 2889: 2879: 2834: 2830: 2820: 2809:. Retrieved 2805: 2796: 2785:. Retrieved 2781: 2772: 2761:. Retrieved 2757: 2734:. Retrieved 2732:. 2023-07-14 2729: 2677:(1): 18–21. 2674: 2670: 2646:. Retrieved 2642: 2633: 2623:, retrieved 2611: 2577:. Retrieved 2573: 2516: 2512: 2456: 2452: 2442: 2432:, retrieved 2420: 2410: 2399:. Retrieved 2395: 2386: 2375:. Retrieved 2371: 2348:. Retrieved 2344: 2335: 2325:, retrieved 2313: 2289:. Retrieved 2285: 2276: 2249: 2245: 2235: 2225:, retrieved 2213: 2203: 2192:. Retrieved 2188: 2138: 2134: 2104:. Retrieved 2100: 2069:. Retrieved 2065: 2034:. Retrieved 2030: 1967: 1964:Biomolecules 1963: 1953: 1920: 1917:Cell Calcium 1916: 1906: 1863: 1859: 1848: 1805: 1801: 1791: 1740: 1736: 1725: 1680: 1676: 1665: 1655:, retrieved 1643: 1633: 1623:, retrieved 1611: 1539: 1535: 1525: 1514:. Retrieved 1512:. 2021-09-15 1509: 1500: 1489:. Retrieved 1485: 1476: 1443: 1439: 1429: 1419:, retrieved 1405: 1371:. Retrieved 1369:. 2021-09-15 1366: 1311: 1307: 1277:. Retrieved 1273: 1216: 1212: 1201: 1158: 1154: 1131:, retrieved 1109: 1099: 1056: 1052: 1042: 1032:, retrieved 1020: 1010: 1000:, retrieved 986: 976: 965:. Retrieved 961: 952: 922:beta-blocker 898: 886:levosimendan 831: 812: 800: 786: 781: 775: 770: 767: 764: 758: 753: 748: 737: 732: 730:Levosimendan 721:Precautions 715:Indications 699:vasodilation 692: 674: 666: 626: 617: 614: 611: 608: 602: 593: 590: 585: 579: 569: 564: 553:Precautions 547:Indications 528: 524:vasodilation 520: 513: 491: 461: 459:Arrhythmias 458: 452: 443: 440:Palpitations 438: 435: 432: 420: 415: 412: 407: 402: 392: 387: 382: 377: 366:Precautions 345: 291: 275: 250: 247: 229: 223: 220: 214: 212:Arrhythmias 211: 208: 206:Skin rashes 205: 202: 199: 190: 180: 175: 131: 124: 102: 30: 29: 4923:Circulation 4897:Mayo Clinic 4837:2434/966600 4732:2434/966600 4575:: 237–251. 4196:Circulation 4063:2434/966600 3766:Circulation 3034:: 145–151. 1743:(1): 1242. 1677:BMC Biology 1308:Circulation 890:transplants 870:vasopressor 858:epinephrine 846:arrhythmias 772:Palpitation 604:Tachycardia 433:Chest pain 429:Arrhythmias 375:Epinephrine 293:Gs proteins 282:epinephrine 236:hypokalemia 5090:Categories 4902:2024-04-05 4878:2024-04-05 4690:2024-04-05 4650:2183/37133 4431:2024-04-05 4418:StatPearls 3998:Cardiology 3874:2024-04-05 3417:(8): 332. 3331:2024-04-05 3211:2024-04-05 3008:2024-04-07 2811:2024-04-05 2787:2024-04-05 2763:2024-04-05 2736:2024-08-11 2648:2024-04-05 2625:2024-04-05 2612:StatPearls 2579:2024-04-05 2434:2024-04-07 2421:StatPearls 2401:2024-04-07 2377:2024-04-07 2350:2024-04-07 2327:2024-04-07 2314:StatPearls 2291:2024-04-07 2227:2024-04-05 2214:StatPearls 2194:2024-04-05 2189:Nurseslabs 2106:2024-04-05 2071:2024-04-05 2062:"Dopamine" 2036:2024-04-05 1970:(4): 488. 1657:2024-04-05 1644:StatPearls 1625:2024-04-05 1612:StatPearls 1516:2024-04-05 1491:2024-04-05 1421:2024-04-05 1373:2024-04-05 1279:2024-04-05 1133:2024-04-05 1034:2024-04-05 1021:StatPearls 1002:2024-04-05 967:2024-04-05 944:References 874:dobutamine 838:Dobutamine 677:troponin C 612:Dizziness 609:Headaches 583:in babies 566:Cilostazol 562:Anagrelide 389:Dobutamine 286:dobutamine 203:Diarrhoea 198:Dizziness 39:myocardium 5058:2058-1742 5001:0098-7484 4943:0009-7322 4846:1388-9842 4788:0028-4793 4741:1388-9842 4659:1388-9842 4591:1178-7074 4532:2110-5820 4516:(1): 45. 4470:1179-5468 4332:0195-668X 4274:2044-6055 4216:0009-7322 4177:2059-1594 4120:1879-0844 4072:1388-9842 4014:0008-6312 3971:1875-6212 3914:1234-1010 3833:0886-022X 3786:0009-7322 3729:2234-943X 3642:2077-0383 3593:1546-9549 3554:2667-8675 3490:0300-0605 3433:2308-3425 3373:1176-6344 3290:0007-1188 3243:0917-5857 3165:1933-6950 3108:1943-0264 3048:2405-5808 2977:1070-5295 2920:1932-6203 2853:1177-8881 2691:2050-0904 2533:0006-4971 2473:0306-5251 2268:2521-3563 2155:0091-6749 1986:2218-273X 1937:0143-4160 1880:1945-0877 1822:0955-0674 1765:2041-1723 1699:1741-7007 1683:(1): 24. 1556:1792-0981 1460:1556-9519 1402:"Digoxin" 1328:0009-7322 1233:1388-9842 1175:0009-7330 1073:2040-4603 882:enoximone 878:milrinone 842:Milrinone 765:Headache 734:Milrinone 688:filaments 615:Insomnia 571:Milrinone 531:platelets 215:Vomiting 182:Digitoxin 177:Digitalis 164:Cautions 63:perfusion 55:Milrinone 35:inotropes 5076:32735316 5019:32125402 4961:38033089 4952:11095842 4854:35083827 4749:35083827 4667:36847113 4609:24899821 4550:38553663 4541:10980676 4488:35153521 4426:29489148 4399:31768269 4350:30295807 4292:35058261 4254:BMJ Open 4234:20385962 4138:31407860 4080:35083827 4022:38237564 4000:: 1–15. 3979:25440597 3932:26289557 3851:31878817 3794:16418450 3747:32509580 3660:36362634 3601:16036037 3508:30909776 3451:37623345 3442:10455812 3391:19183752 3308:20412071 3251:23545748 3183:26556552 3145:Channels 3126:25646377 3066:30417133 2985:14508145 2938:22292006 2890:PLOS ONE 2871:27799745 2709:28096983 2620:32644702 2551:17392505 2491:21649691 2429:32491494 2322:32644702 2222:29494018 2163:12464943 2004:35454077 1945:19230141 1898:28119464 1840:21665456 1783:29593213 1717:29486745 1652:30422499 1620:30480963 1574:25371716 1468:30073854 1336:15210613 1251:30892806 1193:28684623 1091:34964124 1029:30725773 924:, and a 862:dopamine 670:troponin 444:Anxiety 384:Dopamine 5067:8557444 5010:7054840 4796:9036306 4600:4038527 4479:8829716 4390:6848944 4341:7963133 4283:8783828 4225:2861129 4129:6774302 3923:4548701 3842:6968512 3738:7248368 3713:: 779. 3651:9659135 3499:6726822 3382:2605326 3299:2860214 3174:4850049 3117:4315934 3057:6218639 2929:3265514 2898:Bibcode 2862:5076796 2700:5224780 2542:1975837 2482:3195739 1995:9026860 1889:5297430 1831:3175278 1774:5871782 1745:Bibcode 1708:6389107 1565:4218698 1242:6607489 1184:5497788 1082:8773166 909:Digoxin 789:QT wave 768:Nausea 739:Digoxin 641:oocytes 637:meiosis 591:Asthma 340:cytosol 200:Nausea 173:Digoxin 108:digoxin 59:Digoxin 5074:  5064:  5056:  5017:  5007:  4999:  4959:  4949:  4941:  4872:nhs.uk 4852:  4844:  4794:  4786:  4747:  4739:  4665:  4657:  4607:  4597:  4589:  4548:  4538:  4530:  4486:  4476:  4468:  4424:  4397:  4387:  4348:  4338:  4330:  4290:  4280:  4272:  4232:  4222:  4214:  4175:  4136:  4126:  4118:  4078:  4070:  4020:  4012:  3977:  3969:  3930:  3920:  3912:  3849:  3839:  3831:  3792:  3784:  3745:  3735:  3727:  3658:  3648:  3640:  3599:  3591:  3552:  3506:  3496:  3488:  3449:  3439:  3431:  3389:  3379:  3371:  3306:  3296:  3288:  3249:  3241:  3181:  3171:  3163:  3124:  3114:  3106:  3064:  3054:  3046:  2983:  2975:  2936:  2926:  2918:  2869:  2859:  2851:  2758:RxList 2730:AMBOSS 2707:  2697:  2689:  2618:  2549:  2539:  2531:  2489:  2479:  2471:  2427:  2320:  2266:  2252:: 20. 2220:  2161:  2153:  2101:RxList 2002:  1992:  1984:  1943:  1935:  1896:  1886:  1878:  1838:  1828:  1820:  1781:  1771:  1763:  1715:  1705:  1697:  1650:  1618:  1572:  1562:  1554:  1510:nhs.uk 1466:  1458:  1412:  1367:nhs.uk 1334:  1326:  1249:  1239:  1231:  1191:  1181:  1173:  1124:  1089:  1079:  1071:  1027:  993:  938:stroke 884:, and 864:, and 685:myosin 624:CYP3A4 65:, and 2513:Blood 934:atria 920:), a 681:actin 307:into 106:like 5072:PMID 5054:ISSN 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Index

Cardiotonic agents
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

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