Inotropes and inodilators for acute heart failure: Sarcomere active drugs in focus

László Nagy, Piero Pollesello, Zoltán Papp

Research output: Contribution to journalArticlepeer-review


Acute heart failure (AHF) emerges as a major and growing epidemiological concern with high morbidity and mortality rates. Current therapies in patients with acute heart failure rely on different strategies. Patients with hypotension, hypoperfusion, or shock require inotropic support, whereas diuretics and vasodilators are recommended in patients with systemic or pulmonary congestion. Traditionally inotropic agents, referred to as Ca2+ mobilizers load the cardiomyocyte with Ca2+ and thereby increase oxygen consumption and risk for arrhythmias. These limitations of traditional inotropes may be avoided by sarcomere targeted agents. Direct activation of the cardiac sarcomere may be achieved by either sensitizing the cardiac myofilaments to Ca2+ or activating directly the cardiac myosin. In this review, we focus on sarcomere targeted inotropic agents, emphasizing their mechanisms of action and overview the most relevant clinical considerations.

Original languageEnglish (US)
Pages (from-to)199-208
Number of pages10
JournalJournal of cardiovascular pharmacology
Issue number3
StatePublished - Sep 1 2014
Externally publishedYes


  • Acute heart failure syndrome
  • Ca mobilizer
  • Levosimendan
  • Omecamtiv mecarbil
  • Sarcomere targeted agent

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine


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