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正性肌力药物:我们仍在迷茫之中吗?

Inotropic Agents: Are We Still in the Middle of Nowhere?

作者信息

Iorio Anna Maria, Lucà Fabiana, Pozzi Andrea, Rao Carmelo Massimiliano, Di Fusco Stefania Angela, Colivicchi Furio, Grimaldi Massimo, Oliva Fabrizio, Gulizia Michele Masssimo

机构信息

Cardiology Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy.

Cardiology Department, Grande Ospedale Metropolitano, 89129 Reggio Calabria, Italy.

出版信息

J Clin Med. 2024 Jun 26;13(13):3735. doi: 10.3390/jcm13133735.

Abstract

Inotropes are prescribed to enhance myocardial contractility while vasopressors serve to improve vascular tone. Although these medications remain a life-saving therapy in cardiovascular clinical scenarios with hemodynamic impairment, the paucity of evidence on these drugs makes the choice of the most appropriate vasoactive agent challenging. As such, deep knowledge of their pharmacological and hemodynamic effects becomes crucial to optimizing hemodynamic profile while reducing the potential adverse effects. Given this perspective, it is imperative for cardiologists to possess a comprehensive understanding of the underlying mechanisms governing these agents and to discern optimal strategies for their application across diverse clinical contexts. Thus, we briefly review these agents' pharmacological and hemodynamic properties and their reasonable clinical applications in cardiovascular settings. Critical interpretation of available data and the opportunities for future investigations are also highlighted.

摘要

正性肌力药物用于增强心肌收缩力,而血管升压药则用于改善血管张力。尽管这些药物在伴有血流动力学障碍的心血管临床情况中仍然是一种挽救生命的疗法,但关于这些药物的证据匮乏使得选择最合适的血管活性药物具有挑战性。因此,深入了解它们的药理和血流动力学效应对于优化血流动力学状态同时减少潜在不良反应至关重要。从这个角度来看,心脏病专家必须全面了解这些药物的潜在作用机制,并识别出在不同临床情况下应用它们的最佳策略。因此,我们简要回顾这些药物的药理和血流动力学特性以及它们在心血管疾病中的合理临床应用。同时也强调了对现有数据的批判性解读以及未来研究的机会。

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