[Positive inotropic agents].

Despite wide prevalence of beta-blockers and angiotensin-converting enzyme inhibitors for chronic heart failure, their therapeutic efficacy remains limited because effects of these drugs depend largely on pathophysiology of an individual patient. Especially, positive inotropic therapy could be deleterious for some patients, whereas effective in improving symptoms for some patients. Recent clinical experience has led to a concept that in order to be clinically beneficial and safe, positive inotropic agents should only enhance myocardial contractility to a very modest degree in moderately to severely symptomatic patients. Positive inotropic agents could eventually serve as an individualized therapeutic option in effective management of chronic heart failure.