Inotropic therapy in patients with advanced heart failure. A clinical consensus statement from the Heart Failure Association of the European Society of Cardiology

This clinical consensus statement reviews the use of inotropic support in patients with advanced heart failure. The current guidelines only support use of inotropes in the setting of acute decompensated heart failure with evidence of organ malperfusion or shock. However, inotropic support may be rea...

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Authors: Gustafsson, F.; Damman, K.; Nalbantgil, S.; Van Laake, L.W.; Tops, L.F.; Thum, T.; Adamopoulos, S.; Bonios, M.; Coats, A.J.S.; Crespo Leiro, Marisa; Mehra, M.R.; Filippatos, G.; Hill, L.; Metra, M.; Jankowska, E.; de Jonge, N.; Kaye, D.; Masetti, M.; Parissis, J.; Milicic, D.; Seferovic, P.; Rosano, G.; Ben Gal, T.
Format: Article
Publication date:2023
Country:España
Institution:Servizo Galego de Saúde (SERGAS)
Repository:RUNA. Repositorio da Consellería de Sanidade e Sergas
OAI Identifier:oai:runa.sergas.gal:20.500.11940/21648
Online Access:https://portalcientifico.sergas.gal//documentos/642b36b3a1c8a315fd231c7a
http://hdl.handle.net/20.500.11940/21648
Access Level:Open access
Keyword:Humans
Heart Failure
Heart Transplantation
Heart-Assist Devices
Cardiotonic Agents
Cardiology
Cardiovascular Agents
AS A Coruña
CHUAC
Summary:This clinical consensus statement reviews the use of inotropic support in patients with advanced heart failure. The current guidelines only support use of inotropes in the setting of acute decompensated heart failure with evidence of organ malperfusion or shock. However, inotropic support may be reasonable in other patients with advanced heart failure without acute severe decompensation. The clinical evidence supporting use of inotropes in these situations is reviewed. Particularly, patients with persistent congestion, systemic hypoperfusion, or advanced heart failure with need for palliation, and specific situations relevant to implantation of left ventricular assist devices or heart transplantation are discussed. Traditional and novel drugs with inotropic effects are discussed and use of guideline-directed therapy during inotropic support is reviewed. Finally, home inotropic therapy is described, and palliative care and end-of-life aspects are reviewed in relation to management of ongoing inotropic support (including guidance for maintenance and weaning of chronic inotropic therapy support).

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