Rusca Marco, Liaudet Lucas
Service de médecine intensive adulte, CHUV, 1011 Lausanne.
Rev Med Suisse. 2009 Dec 9;5(229):2512-5.
Acute Heart Failure Syndromes are defined as the rapid progression, or de novo presentation, of heart failure signs and symptoms. When clinical signs of low cardiac output are present, therapy with positive inotropic agents in an acute cardiac care unit is mandatory. Three classes of inotropic drugs are currently available, including beta-adrenergic agonists (especially dobutamine), phosphodiesterase inhibitors (such as milrinone) and the recently developed calcium sensitizers (levosimendan). In this article, we summarize the mechanisms of action of these different classes of drugs, and also discuss important issues regarding their clinical indications and the potential risks associated with their use.
急性心力衰竭综合征被定义为心力衰竭体征和症状的快速进展或新发表现。当出现低心排血量的临床体征时，在急性心脏护理单元使用正性肌力药物进行治疗是必要的。目前有三类正性肌力药物，包括β肾上腺素能激动剂（尤其是多巴酚丁胺）、磷酸二酯酶抑制剂（如米力农）以及最近研发的钙增敏剂（左西孟旦）。在本文中，我们总结了这些不同类别药物的作用机制，并讨论了关于其临床适应证以及使用相关潜在风险的重要问题。
