A pragmatic approach to the use of inotropes for the management of acute and advanced heart failure: An expert panel consensus

Dimitrios Farmakis, Piergiuseppe Agostoni, Loant Baholli, Andrei Bautin, Josep Comin-Colet, Maria G. Crespo-Leiro, Francesco Fedele, Jose Manuel García-Pinilla, George Giannakoulas, Francesco Grigioni, Marcin Gruchała, Finn Gustafsson, Veli Pekka Harjola, Tal Hasin, Antoine Herpain, Efstathios K. Iliodromitis, Kristjan Karason, Matti Kivikko, Lucas Liaudet, Jana Ljubas-MačekMarco Marini, Josep Masip, Alexandre Mebazaa, Maria Nikolaou, Petr Ostadal, Pentti Põder, Piero Pollesello, Eftihia Polyzogopoulou, Gerhard Pölzl, Carsten Tschope, Marjut Varpula, Dirk von Lewinski, Bojan Vrtovec, Mehmet Birhan Yilmaz, Endre Zima, John Parissis

Research output: Contribution to journalArticlepeer-review


Inotropes aim at increasing cardiac output by enhancing cardiac contractility. They constitute the third pharmacological pillar in the treatment of patients with decompensated heart failure, the other two being diuretics and vasodilators. Three classes of parenterally administered inotropes are currently indicated for decompensated heart failure, (i) the beta adrenergic agonists, including dopamine and dobutamine and also the catecholamines epinephrine and norepinephrine, (ii) the phosphodiesterase III inhibitor milrinone and (iii) the calcium sensitizer levosimendan. These three families of drugs share some pharmacologic traits, but differ profoundly in many of their pleiotropic effects. Identifying the patients in need of inotropic support and selecting the proper inotrope in each case remain challenging. The present consensus, derived by a panel meeting of experts from 21 countries, aims at addressing this very issue in the setting of both acute and advanced heart failure.

Original languageEnglish
Pages (from-to)83-90
Number of pages8
JournalInternational Journal of Cardiology
Publication statusPublished - Dec 15 2019


  • Acute heart failure
  • Advanced heart failure
  • Dobutamine
  • Inodilators
  • Inotropes
  • Levosimendan
  • Milrinone
  • Norepinephrine

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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