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window.loswp.shouldShowBulkDownload = true; window.loswp.showSignupCaptcha = false window.loswp.willEdgeCache = false; window.loswp.work = {"work":{"id":11000946,"created_at":"2015-02-22T18:47:54.485-08:00","from_world_paper_id":131833418,"updated_at":"2024-11-16T13:08:10.363-08:00","_data":{"grobid_abstract":"Acute heart failure (AHF) represents a major public health problem due to its high prevalence, high rates of mortality and readmissions and significant healthcare costs. Patients with AHF and low cardiac output represent a small subgroup of patients with very high mortality rates that require inotropic support to improve cardiac systolic function. Classical inotropic agents, such as 1-adrenergic agonists (dobutamine, dopamine) and phosphodiesterase III inhibitors (milrinone, enoximone) improve symptoms and hemodynamics by increasing free intracellular Ca 2+ levels, but also increase myocardial O 2 demands and exert arrhythmogenic effects. These actions explain why these drugs increase both short-and long-term mortality, particularly in patients with AHF and coronary artery disease. Thus, we need new inotropic agents that do not increase cytosolic Ca 2+ or myocardial oxygen demands or produce arrhythmogenesis for the treatment of high-risk patients with (AHF) and low cardiac output. This review describes three new classes of investigational agents: levosimendan, a calcium sensitizer and potassium channel opener, istaroxime, the first new luso-inotropic agent and cardiac myosin activators.","publication_date":"2009,,","publication_name":"Cardiovascular \u0026 Hematological Disorders-Drug Targets","grobid_abstract_attachment_id":"46973085"},"document_type":"paper","pre_hit_view_count_baseline":null,"quality":"high","language":"en","title":"Investigational Positive Inotropic Agents for Acute Heart Failure","broadcastable":true,"draft":null,"has_indexable_attachment":true,"indexable":true}}["work"]; window.loswp.workCoauthors = [26636038]; window.loswp.locale = "en"; window.loswp.countryCode = "SG"; window.loswp.cwvAbTestBucket = ""; window.loswp.designVariant = "ds_vanilla"; window.loswp.fullPageMobileSutdModalVariant = "full_page_mobile_sutd_modal"; window.loswp.useOptimizedScribd4genScript = false; window.loswp.appleClientId = 'edu.academia.applesignon';</script><script defer="" src="https://accounts.google.com/gsi/client"></script><div class="ds-loswp-container"><div class="ds-work-card--grid-container"><div class="ds-work-card--container js-loswp-work-card"><div class="ds-work-card--cover"><div class="ds-work-cover--wrapper"><div class="ds-work-cover--container"><button class="ds-work-cover--clickable js-swp-download-button" data-signup-modal="{"location":"swp-splash-paper-cover","attachmentId":46973085,"attachmentType":"pdf"}"><img alt="First page of “Investigational Positive Inotropic Agents for Acute Heart Failure”" class="ds-work-cover--cover-thumbnail" src="https://0.academia-photos.com/attachment_thumbnails/46973085/mini_magick20190208-16142-bzb3b8.png?1549629501" /><img alt="PDF Icon" class="ds-work-cover--file-icon" src="//a.academia-assets.com/assets/single_work_splash/adobe.icon-574afd46eb6b03a77a153a647fb47e30546f9215c0ee6a25df597a779717f9ef.svg" /><div class="ds-work-cover--hover-container"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span><p>Download Free PDF</p></div><div class="ds-work-cover--ribbon-container">Download Free PDF</div><div class="ds-work-cover--ribbon-triangle"></div></button></div></div></div><div class="ds-work-card--work-information"><h1 class="ds-work-card--work-title">Investigational Positive Inotropic Agents for Acute Heart Failure</h1><div class="ds-work-card--work-authors ds-work-card--detail"><a class="ds-work-card--author js-wsj-grid-card-author ds2-5-body-md ds2-5-body-link" data-author-id="26636038" href="https://independent.academia.edu/RicardoGomez35"><img alt="Profile image of Ricardo Gomez" class="ds-work-card--author-avatar" src="https://0.academia-photos.com/26636038/7413875/8333582/s65_ricardo.gomez.jpg_oh_a0642e96cb2649b1ab7b244a5b9d45d0_oe_5553ee5c___gda___1431168205_f08c23e6eb8d759d6261e2b6fa5cb2e0" />Ricardo Gomez</a></div><div class="ds-work-card--detail"><p class="ds-work-card--detail ds2-5-body-sm">2009, Cardiovascular & Hematological Disorders-Drug Targets</p><div class="ds-work-card--work-metadata"><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">visibility</span><p class="ds2-5-body-sm" id="work-metadata-view-count">…</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">description</span><p class="ds2-5-body-sm">13 pages</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">link</span><p class="ds2-5-body-sm">1 file</p></div></div><script>(async () => { const workId = 11000946; 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Perrone</a></div><p class="ds-related-work--metadata ds2-5-body-xs">International Journal of Cardiology, 2005</p><p class="ds-related-work--abstract ds2-5-body-sm">The clinician&amp;amp;amp;#39;s primary objective in treating a patient with decompensated heart failure is rapid and effective stabilization. This goal often is achieved through the use of inotropic support. Classic inotropic agents (beta-adrenergic agonists and phosphodiesterase III inhibitors) can provide short-term hemodynamic benefits, but their long-term use has been correlated with poor survival rates. Calcium sensitizers comprise a new drug class that offers hemodynamic and symptomatic improvements without increasing cAMP and intracellular calcium concentrations. These agents enhance contractility without a concurrent increase in the risk of cardiac events and thus represent a significant improvement over classic positive inotropic agents. Levosimendan is the most potent calcium sensitizer to date, exhibiting a unique dual mechanism of action that combines a positive inotropic action mediated via calcium sensitization and a vasodilator property via ATP-dependent potassium channels. Available clinical data suggest that calcium sensitizer agents represent a promising class of inotropic agents in a field that has seen few advances in recent decades.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Calcium sensitizer agents: A new class of inotropic agents in the treatment of decompensated heart failure","attachmentId":42118615,"attachmentType":"pdf","work_url":"https://www.academia.edu/19015349/Calcium_sensitizer_agents_A_new_class_of_inotropic_agents_in_the_treatment_of_decompensated_heart_failure","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/19015349/Calcium_sensitizer_agents_A_new_class_of_inotropic_agents_in_the_treatment_of_decompensated_heart_failure"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="2" data-entity-id="25748259" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/25748259/Agents_with_inotropic_properties_for_the_management_of_acute_heart_failure_syndromes_Traditional_agents_and_beyond">Agents with inotropic properties for the management of acute heart failure syndromes. 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Three classes of inotropic drugs are currently used, including beta-adrenergic agonists (especially dobutamine), phosphodiesterase inhibitors (such as milrinone) and the recently developed calcium sensitizers such as levosimendan. The classic inotropic drugs offer short-term haemodynamic enhancement in heart failure patient and their use has been connected with poor prognosis. The inotropic drugs, the Ca 2+-sensitizers, may offer a choice of long-lasting result.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"The Role of Calcium-Sensitizer Levosimendan for the Treatment of Heart Failure","attachmentId":56057526,"attachmentType":"pdf","work_url":"https://www.academia.edu/36160321/The_Role_of_Calcium_Sensitizer_Levosimendan_for_the_Treatment_of_Heart_Failure","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/36160321/The_Role_of_Calcium_Sensitizer_Levosimendan_for_the_Treatment_of_Heart_Failure"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="5" data-entity-id="29119796" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/29119796/Newer_treatments_for_decompensated_heart_failure_focus_on_levosimendan">Newer treatments for decompensated heart failure: focus on levosimendan</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="54773906" href="https://independent.academia.edu/FerencFollath">Ferenc Follath</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Drug Design, Development and Therapy, 2009</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Newer treatments for decompensated heart failure: focus on levosimendan","attachmentId":49566558,"attachmentType":"pdf","work_url":"https://www.academia.edu/29119796/Newer_treatments_for_decompensated_heart_failure_focus_on_levosimendan","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/29119796/Newer_treatments_for_decompensated_heart_failure_focus_on_levosimendan"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="6" data-entity-id="80663174" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/80663174/A_pragmatic_approach_to_the_use_of_inotropes_for_the_management_of_acute_and_advanced_heart_failure_An_expert_panel_consensus">A pragmatic approach to the use of inotropes for the management of acute and advanced heart failure: An expert panel consensus</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="41032081" href="https://independent.academia.edu/KKarason">K. 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