Continuous Intravenous Inotropes as a Bridge to Myocardial Recovery

Background:

Currently, the long-term inotropic therapy in advanced heart failure (HF) patients is considered palliative and even deleteriou. These data, however, are derived from studies conducted in the pre neurohormonal-directed therapy era, while contemporary reports have demonstrated the safety of continuous inotropic therapy. Furthermore, the utilization of continuous inotropes might enable advance HF patients to tolerate HF disease-modifying therapies, and therefore, might represent an option for myocardial recovery. Here we present a case-series of advanced HF patients who showed myocardial recovery after a prolonged combined treatment with inotropes and guidelines-recommended HF therapy.

Methods and results:

Baseline parameters, therapies and outcomes of 3 consecutive advanced HF patients who were seen and followed at the Keck Medical Center are presented in table 1.

Conclusion:

In patients unsuitable or reluctant to heart transplantation or ventricular assist device implantation, the combination of continuous inotropic therapy and guidelines-recommended HF therapy might represent an option for myocardial recovery. Prospective studies are required to validate this observation.