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EDITORIAL The Future for Inotropes in Heart Failure. Do Not Throw the Baby Out With the Bathwater! Piero Pollesello, PhD* and Zoltán Papp, MD, PhD† e listened with interest to a lively debate during the recent European Society of WCardiology (ESC) annual congress in Barcelona. The question under consideration was the role of inotropes in heart failure at large: “.are they dead and buried?” The answer that emerged from an amicable, but keenly contested exchange between Professor Milton Packer and Professor Gerhard Pölzl was that “.it depends on which inotrope and on which subtype of heart failure.” We summarize in this Comment some of the points that attracted our attention. “Inotrope” is nowadays a much more sophisticated and capacious term than hitherto with a recent classification proposing a subdivision in the 3 categories of calcitropes, myotropes, and mitotropes : (1) Calcitropes are drugs increasing contractility by an ele- vation of intracellular calcium, such as the beta-agonist dobutamine, the phosphodiesterase inhibitor milrinone, or the sodium pump inhibitor digoxin; (2) Myotropes are drugs increas- ing contractility by a direct interaction with the contractile proteins, such as the troponin C activator levosimendan or the myosin activator omecamtiv mecarbil; (3) Mitotropes are drugs
Journal of Cardiovascular Pharmacology – Wolters Kluwer Health
Published: Jan 1, 2023
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