INOTROPIC AGENTS AND ADRENERGIC AGONISTS AS THERAPY FOR CONGESTIVE-HEART-FAILURE

The primary cardiac abnormality in patients with congestive heart failure due to a dilated cardiomyopathy is pump failure. Therefore, we intuitively expect that inotropic agents, drugs that increase the contractility of the heart, would be beneficial in patients with heart failure. Because the most potent mechanism for increasing cardiac contractility is the adrenergic pathway, agents have been developed that augment cardiac contractility via stimulation of adrenergic receptors. Alternately, other pharmaceuticals have been developed that interact with more distal sites in the excitation contraction-coupling pathway. However, with the exception of digoxin, no inotropic agents have proven to be of long-term benefit in patients with congestive failure. This review briefly outlines recent observations on the use of new inotropic agents and adrenergic agonists in the treatment of patients with congestive heart failure.