[Chronic left heart ventricle failure and inotropic stimulation].
E S Myhre, TORSTEIN GUNDERSEN, Kenneth Dickstein, Torstein Hole, JOHN K. KJEKSHUS, Per K. Rønnevik, Paul Smith, Arne S. Westheim
Abstract
E S Myhre, TORSTEIN GUNDERSEN, Kenneth Dickstein, Torstein Hole, JOHN K. KJEKSHUS, Per K. Rønnevik, Paul Smith, Arne S. Westheim
Abstract
Congestive left heart failure can be treated using three main strategies: change preload to optimize the Frank-Starling relationship, decrease after-load to reduce external work and increase cardiac contractility by inotropic stimulation. The third option is reviewed in this article, which discusses the pharmacological and clinical effects of different inotropic drugs as known in 1994. It is concluded that digitalis should be considered apart from other inotropic drugs. Even when in sinus rhythm, digitalis seems reasonable as an adjuvans to after-load reduction and diuretics. Chronic use of other inotropic drugs for congestive left heart failure is not recommended.
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Congestive left heart failure can be treated using three main strategies: change preload to optimize the Frank-Starling relationship, decrease after-load to reduce external work and increase cardiac contractility by inotropic stimulation. The third option is reviewed in this article, which discusses the pharmacological and clinical effects of different inotropic drugs as known in 1994. It is concluded that digitalis should be considered apart from other inotropic drugs. Even when in sinus rhythm, digitalis seems reasonable as an adjuvans to after-load reduction and diuretics. Chronic use of other inotropic drugs for congestive left heart failure is not recommended.
Key concepts: Inotrope, Heart failure, Digitalis, Preload, Medicine, Contractility, Cardiology, Internal medicine