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Topic: Inotropic

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	CHFpatients.com - IV Heart Failure Drugs
		Using IV inotropes is still controversial among doctors because they increase your risk of death.
		About 10 years ago, Levine began noticing "that a number of patients taking IV inotropes improved so much that they didn't need a transplant." He and his wife, Dr. Arlene Levine, began to prescribe the therapy to be used at home.
		The Levines' study of 49 patients on IV inotropes was published in the March issue of Clinical Cardiology.
	www.chfpatients.com /inotropes.htm (4993 words)

	Inotrope - Wikipedia, the free encyclopedia
		An inotrope is an agent which increases or decreases the force or energy of muscular contractions.
		Negatively inotropic (in·o·trop·ic) (in²o-trop¢ik) [ino- + -tropic] agents weaken the force of muscular contraction.
		The choice of drug depends on the clinical circumstance and may be used singly or in combination with vasodilator drugs: dopamine (previously thought have a renal protective effect at low doses, but subsequently debunked by studies.
	en.wikipedia.org /wiki/Inotrope (310 words)

	Inotropic / chronotropic drugs: (Site not responding. Last check: 2007-11-02)
		When administered therapeutically, the drug exerts its principal effects at alpha1, alpha 2 and beta 1 receptors where it is both a potent inotrope and vasoconstrictor.
		The phosphodiesterase type III inhibitors (PDEIs) inhibit the hydrolysis of cAMP and thus, as inotropes, act synergistically with the sympathomimetic agents.
		In practice, it is difficult to separate the negative chronotropic and inotropic effects of the beta blockers.
	www.manbit.com /PAC/chapters/P34.cfm (2073 words)

	CHFpatients.com - IV Heart Failure Drugs - Page 2
		In case the usual intervals being tested are too long, we used intermittent inotropes to mimic short periods of exercise.
		Title: Pulsed inotropic therapy in chronic heart failure Source: Adamopoulos S, Piepoli M, Qiang F et al: Effects of pulsed Beta-stimulant therapy on Beta-adrenoceptors and chronotropic responsiveness in chronic heart failure.
		In controlled trials of chronic oral therapy with various such agents, symptoms were not consistently relieved, and the cyclic-AMP-dependent inotropes were consistently associated with increased risk of hospitalization and death.
	www.chfpatients.com /inotropes_old.htm (2442 words)

	Negative inotropic effect of albumin resuscitation for shock - Wheeless' Textbook of Orthopaedics
		This negative inotropic effect was associated with impaired oxygenation, as reflected by an increased ratio of inspired oxygen per arterial oxygen tension (0.62 +/ - 0.06 vs. 0.33 +/- 0.1).
		Finally, 24 of the 46 albumin-treated patients were digitalized for heart failure, compared to only 11 of the 48 nonalbumin patients.
		Pending subsequent studies, albumin should be considered a potentially negative inotropic agent.
	www.wheelessonline.com /ortho/negative_inotropic_effect_of_albumin_resuscitation_for_shock (216 words)

	Peroxynitrite is a positive inotropic agent in atrial and ventricular fibres of the frog heart -- Chesnais et al. 521 ...
		The negative inotropic effect of the nitrosothiol (a 39 % decrease in the active tension) was antagonised by LY 83583.
		The positive inotropic effect of SIN-1 (100 µM) was not modified by the change in the frequency of stimulation (0·2 and 0·1 Hz) in the control solution.
		In addition, the positive inotropic effect of SIN-1 was totally abolished in sodium-free solutions, suggesting the involvement of the sodium-calcium exchanger in the positive inotropic effect of this compound.
	jp.physoc.org /cgi/content/full/521/2/375 (7946 words)

	British Journal of Pharmacology - Ca2+-sensitizing effect is involved in the positive inotropic effect of troglitazone (Site not responding. Last check: 2007-11-02)
		This inotropic effect of troglitazone was not inhibited by pretreatment with carbachol (muscarine receptor agonist), H89 (protein kinase A inhibitor), U73122 (phospholipase C inhibitor), H7 (protein kinase C inhibitor), verapamil (L-type Ca channel antagonist), thapsigargin (Ca -adenosine triphosphatase inhibitor) or ryanodine (ryanodine receptor opener).
		Therefore, it is of great importance to clarify the mechanisms of the positive inotropic effect of troglitazone not only for treating diabetic patients with heart failure, but also for developing new unique agents which would exert positive inotropic and vasorelaxant effects without increasing the heart rate.
		The inotropic effect of troglitazone was not inhibited by pretreatment with verapamil in isolated perfused hearts (Figure 2A).
	www.nature.com /bjp/journal/v133/n8/full/0704212a.html (3712 words)

	Enhanced inotropic response to dobutamine in strength-trained subjects with left ventricular hypertrophy -- Suman et ...
		The inotropic sensitivity to dobutamine, determined by the slope of the linear portion of the systolic shortening dobutamine
		Inotropic sensitivity was assessed by analysis of slope of linear portion of LV systolic shortening dose-response curve of dobutamine.
		Relationship between inotropic sensitivity to dobutamine (defined as slope of linear portion of FS dobutamine dose-response curve) and LV mass (LVM) normalized for LBM in strength-trained subjects.
	jap.physiology.org /cgi/content/full/88/2/534 (3032 words)

	Diminished Inotropic Response to Amrinone in Ventricular Myocytes from Myopathic Hamsters Is Linked to Depression of ...
		The positive inotropic effect of amrinone can be observed with steps to 0 mV when cells are activated by steps from negative potentials in normal but not CM myocytes.
		Therefore, the positive inotropic effect of increased SR Ca is not countered by the decrease in the magnitude of I
		Movsesian MA (2002) PDE3 cyclic nucleotide phosphodiesterases and the compartmentation of cyclic nucleotide-mediated signalling in cardiac myocytes.
	jpet.aspetjournals.org /cgi/content/full/310/2/761 (6265 words)

	Comparison between Alpha-1 Adrenoceptor-Mediated and Beta Adrenoceptor-Mediated Inotropic Components Elicited by ...
		Characterization of the inotropic responses to phenylephrine and norepinephrine
		Qualitative characteristics of the inotropic responses to norepinephrine in the presence and absence of adrenergic blocking agents.
		Dose-response relationships of the inotropic responses to norepinephrine in the presence of adrenergic blockers.
	www.jpet.org /cgi/content/full/280/2/721 (5457 words)

	The Paradoxical Positive Inotropic Effect of Sevoflurane in Healthy and Cardiomyopathic Hamsters -- Vivien et al. 95 ...
		inotropic effect of sevoflurane in rat papillary muscles (5).
		Concentration-dependent inotropic effects of halothane, isoflurane and sevoflurane on rat ventricular myocytes.
		Azuma M, Matsumura C, Kemmotsu O. Inotropic and electrophysiologic effects of propofol and thiamylal in isolated papillary muscles of the guinea pig and the rat.
	www.anesthesia-analgesia.org /cgi/content/full/95/1/31 (4096 words)

	Inotropic effects of ETB receptor stimulation and their modulation by endocardial endothelium, NO, and prostaglandins ...
		Inotropic effects of ETB receptor stimulation and their modulation by endocardial endothelium, NO, and prostaglandins -- Leite-Moreira and Brás-Silva 287 (3): H1194 -- AJP - Heart and Circulatory Physiology
		Chu L and Endoh M. Biphasic inotropic response to endothelin-1 in the presence of various concentrations of norepinephrine in dog ventricular myocardium.
		Inotropic effects of endothelin in ferret ventricular myocardium.
	ajpheart.physiology.org /cgi/content/full/287/3/H1194 (3987 words)

	The Inotropic and Lusitropic Effects of Ketamine in Isolated Human Atrial Myocardium: The Effect of Adrenoceptor ...
		The Inotropic and Lusitropic Effects of Ketamine in Isolated Human Atrial Myocardium: The Effect of Adrenoceptor Blockade -- Hanouz et al.
		Inotropic effects of propofol, thiopental, midazolam, etomidate, and ketamine on isolated human atrial muscle.
		Electrophysiologic mechanisms responsible for inotropic responses to ketamine in guinea pig and rat myocardium.
	www.anesthesia-analgesia.org /cgi/content/full/99/6/1689 (2757 words)

	[No title] (Site not responding. Last check: 2007-11-02)
		Especially in the hemodynamically unstable (heart failure) patient, repeated adjustment of vasoactive and inotropic drug infusion rates is needed to maintain cardiac output and left ventricular preload and afterload within an acceptable range (7).
		We did not include the control of cardiac output because we felt that the current techniques to monitor cardiac output continuously during cardiac surgery are not yet reliable enough to be used as the input of a closed-loop system.
		For the control of arterial hypotension in patients with low cardiac output, we preferred use of DOBU over the inotropic drug dopamine because of the nonlinear response to dopamine at lower infusion rates (11).
	www.sopami.hpg.ig.com.br /artigo14.htm (4805 words)

	Heart failure treatment - WebMD
		Inotropic therapy is used in end-stage heart failure to help relieve and control heart failure symptoms so that you are better able to perform your daily activities.
		Inotropic therapy, also known as heart pump medication, stimulates an injured or weakened heart to pump harder.
		Inotropic therapy is first administered in the hospital where you can be closely monitored.
	www.webmd.com /heart-disease/treating-severe-failure (502 words)

	Energy Citations Database (ECD) - Energy and Energy-Related Bibliographic Citations (Site not responding. Last check: 2007-11-02)
		The EC50, values for the negative inotropic effect of acetylcholine were 3.3 x 10(-7) M in rat and guinea pig atria and 4.1 x 10(-6) M in rabbit atria.
		There was no correlation between the species differences in the negative inotropic effect of acetylcholine in atria and the density or affinity of acetylcholinesterase or muscarinic receptors.
		Species differences in the negative inotropic effect of acetylcholine may be caused by differences in the coupling between myocardial muscarinic receptors and the ion channels that mediate negative inotropy.
	www.osti.gov /energycitations/product.biblio.jsp?osti_id=166860 (262 words)

	6_rev3
		The negative inotropic effect of a high concentration of SNAP was blocked by the specific blocker of PKG KT 5823 (1 ¥mol/L).
		The positive inotropic response of low-dose SNAP was maintained even in the presence of the specific blocker of guanylyl cyclase (GC) 1H-[1,2,4] oxadiazolo [4,3 —a] quinoxalin-1-one) (ODQ, 10 ¥mol/L) alone, but was completely abolished in the presence of ODQ plus the specific inhibitor of cAMP analog Rp8CPTcAMPS as well as the NO scavenger oxyhemoglobin.
		This pathway is the principal pathway by which conventional inotropes increase the contractile state of the heart.
	ctdigest.com /Sept99/6_rev3/6_rev3.html (639 words)

	Inotropic Support of the Failing Heart
		In practice, none of the newer inotropes has been shown to be more effective than epinephrine and, if we are to practice evidence based medicine, this is the drug of choice until proved otherwise.
		In patients with moderate to poor ventricular function where an inotrope as well as afterload reduction are required, milrinone and epinephrine are a sensible combination.
		Epinephrine is still the first line inotrope of choice and has been shown in many studies to provide inotropy with the least side effects.
	www.euroanesthesia.org /education/rc_vienna/04rc2.HTM (1761 words)

	Anaesthesia - Critical Care Blog » Inotropic support
		The patients underwent implantation of left ventricular assist devices and were treated with lisinopril, carvedilol, spironolactone, and losartan to enhance reverse remodeling.
		In this single-center study, we found that sustained reversal of severe heart failure secondary to nonischemic cardiomyopathy could be achieved in selected patients with the use of a left ventricular assist device and a specific pharmacologic regimen.
		Increased intracellular calcium may be caused by an increase in the intracellular concentration of cyclic adenosine monophosphate, which can be caused by ß-adrenergic stimulation or by decreasing the catabolism of cyclic adenosine monophosphate via phosphodiesterase inhibition (2).
	theminiblog.co.uk /dad/category/inotropic-support (716 words)

	[No title]
		Even though a higher risk of death (mortality) was found with long-term outpatient IV dobutamine use, and with oral pirbuterol and xamoterol, there was hope that inotropic drugs acting in different ways might do the trick.
		For patients who respond to standard drug therapy, there is now no role for inotropic drugs but therapy cannot be the same for all CHF patients.
		Looking back, it has been clear for some time that inotropic therapy does not have a role in the treatment of most heart failure patients.
	www.cs.yale.edu /homes/lr288/IWSpring2004/info/Inotropic_HF_treatment.txt (1169 words)

	inotropic Search Results From Healthline
		NEJM Evaluation of a new bipyridine inotropic agent milrinone in patients with severe congestive...
		Four patients died after a mean of 4.8 months of therapy, and three patients with severe underlying coronary-artery disease and angina pectoris required ad...
		Effects of hypercapnia on hemodynamic inotropic lusitropic and electrophysiologic indices in huma...
	www.healthline.com /search?q1=inotropic (197 words)

	Non-Cyclic AMP-Dependent, Positive Inotropic Cyclodepsipeptides with Negative Chronotropy -- Tsunoo and Kamijo 290 (3): ...
		Colucci WS, Wright RF and Braunwald E (1986) New positive inotropic agents in the treatment of heart failure: Mechanisms of action and recent clinical developments.
		Packer M, Medina N and Yushak M (1984) Hemodynamic and clinical limitations of long-term inotropic therapy with amrinone in patients with severe chronic heart failure.
		Yeh SF, Pan W, Ong G-T, Chiou A-J, Chuang C-C, Chiou S-H and Wu S-H (1996) Study of structure-activity correlation in destruxins, a class of cyclodepsipeptides possessing suppressive effect on the generation of hepatitis B virus surface antigen in human hepatoma cells.
	jpet.aspetjournals.org /cgi/content/full/290/3/1006 (4136 words)

	Apria - resources - News (Site not responding. Last check: 2007-11-02)
		Considering the role of inducible NOS (iNOS) in hemodynamic abnormalities of cirrhotic rats, the chronotropic and inotropic responses of cirrhotic rats to isoproterenol stimulation were also assessed in the presence of aminoguanidine (a selective inhibitor of iNOS, 3 x 10(-4) m).
		Although the maximum effects of isoproterenol on chronotropic and inotropic responses were significantly reduced in cirrhotic rats, there was no difference in half-maximal effective concentrations of isoproterenol in these concentration-response curves.
		The basal abnormalities and the attenuated chronotropic and inotropic responses to isoproterenol were completely corrected by the administration of naltrexone, L-NAME and aminoguanidine.
	www.apria.com /resources/1,2725,494-589125,00.html (542 words)

	Na+-Channel Modulation, a New Principle of Inotropic Intervention: Effects on Hemodynamic and Myocardial Energetics in ... (Site not responding. Last check: 2007-11-02)
		of inotropic intervention on hemodynamics and myocardial energetics
		inotropic effect was demonstrated by us for the first time (11).
		Baumgart D, Ehring T, Krajcar M, Skyschally A, Heusch G 1994 Characterization of the inotropic and arrhythmogenic action of the sodium channel activator BDF 9148: in comparison to its S-enantiomer BDF 9196, to its congener DPI 201-106, to norepinephrine, and to ouabain.
	www.pedresearch.org /cgi/content/full/54/6/875 (3935 words)

	Hexosamine Pathway Is Responsible for Inhibition by Diabetes of Phenylephrine-Induced Inotropy -- Pang et al. 53 (4): ...
		The average changes over time in RPP in response to PE are shown, demonstrating that a short period of diabetes (2–6 days) blunts the inotropic effects caused by PE and that a 45-min pretreatment with azaserine (20 µmol/l), an inhibitor of the hexosamine biosynthetic pathway, partially reverses the diabetes-inhibited inotropy.
		Positive inotropic effects of PE are inhibited by diabetes, whereas azaserine partially reverses this inhibition.
		pathway as being responsible for the inhibition in inotropic
	diabetes.diabetesjournals.org /cgi/content/full/53/4/1074 (5552 words)

	Optimizing Treatment of Patients with Advanced Heart Failure: Currents: UI Health Care
		However, the use of intermittent inotropic agents remains controversial because their efficacy and safety has not been convincingly demonstrated.
		Inotropic therapy can include either phosphodiesterase inhibitors, such as milrinone, or ß-adrenergic agonists, such as dobutamine.
		The rationale for the combination is that the addition of a ß-blocker to inotropic agents might eliminate the adverse effects associated with their long-term use.
	uihealthcare.com /news/currents/vol1issue3/congestiveheartfailure.html (1081 words)

	Clinical Trial: Home Inotropic Therapy in Children
		Inotropic therapy is a well-established practice for children with advanced congestive heart failure (CHF).
		Inotropes are intravenous medications to help the heart pump stronger and prolong life while awaiting heart transplantation.
		In adults, home inotropic therapy has been shown to be a safe and cost-effective bridge to transplantation.
	clinicaltrials.gov /ct/show/NCT00327899 (320 words)

	Optimizing Treatment of Patients with Advanced Heart Failure: Currents: University of Iowa Health Care
		However, the use of intermittent inotropic agents remains controversial because their efficacy and safety has not been convincingly demonstrated.
		After all the above have been attempted, there remains a small population of refractory unstable patients in whom intermittent inotropic infusions may be of benefit (Table 1).
		The rationale for the combination is that the addition of a ß-blocker to inotropic agents might eliminate the adverse effects associated with their long-term use.
	www.uihealthcare.com /news/currents/vol1issue3/congestiveheartfailure.html (1083 words)

	Abstracts: NU Tech Expo and Software Showcase
		The effects of distilled water (diH2O), hypo and hyperosmotic NaCl on inotropic responses of isolated rat hearts were studied.
		The myocardium demonstrated a dose-dependent inotropic behavior with respect to osmolarity variations in the coronary circulation.
		Decrease in osmolarity causes a positive inotropic response while an increase in osmolarity causes a negative inotropic response.
	www.atsweb.neu.edu /edtech/showcase/old/A_osmotic.html (356 words)

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