Cardiac Calcitropes, Myotropes, and Mitotropes: JACC Review Topic of the Week
Name:
Publisher version
View Source
Access full-text PDFOpen Access
View Source
Check access options
Check access options
Date
2019Journal
Journal of the American College of CardiologyPublisher
Elsevier USAType
Article
Metadata
Show full item recordAbstract
The term “inotrope” is familiar and intimately connected with pharmaceuticals clinically used for treatment of low cardiac output with cardiogenic shock. Traditional inotropic agents exert their effect by modulating calcium signaling in the myocardium. Their use is associated with poor long-term outcomes. Newer molecules in development intend to break from calcium mediation and the associated detrimental long-term effects by targeting distinct mechanisms of action to improve cardiac performance. Thus, “inotropy” does not sufficiently describe the range of potential novel pharmaceutical products. To enhance communication around and evaluation of current, emerging, and potential therapies, this review proposes a novel nuanced and holistic framework to categorize pharmacological agents that improve myocardial performance based on 3 myocardial mechanisms: calcitropes, which alter intracellular calcium concentrations; myotropes, which affect the molecular motor and scaffolding; and mitotropes, which influence energetics. Novel chemical entities can easily be incorporated into this structure, distinguishing themselves based on their mechanisms and clinical outcomes. © 2019 The AuthorsIdentifier to cite or link to this item
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85064687087&doi=10.1016%2fj.jacc.2019.02.051&partnerID=40&md5=093c6e05e32b9dc22bbeb2224d549f66; http://hdl.handle.net/10713/10568ae974a485f413a2113503eed53cd6c53
10.1016/j.jacc.2019.02.051
Scopus Count
Collections
Related articles
- Inotropic therapies in heart failure and cardiogenic shock: an educational review.
- Authors: DesJardin JT, Teerlink JR
- Issue date: 2021 Aug 24
- Inotropes.
- Authors: Francis GS, Bartos JA, Adatya S
- Issue date: 2014 May 27
- [New cardiotonic/inodilator agents: energetic aspects].
- Authors: Hasenfuss G
- Issue date: 1992
- [Calcium sensitizers--a new group of drugs that increase myocardium contractility].
- Authors: Laine M, Lehtonen L, Nieminen MS
- Issue date: 2000
- [Inotrope therapy in acute heart failure: a critical review of clinical and scientific evidence for levosimendan in the context of traditional treatment].
- Authors: Ambrosio G, Di Lenarda A, Fedele F, Gabrielli D, Metra M, Oliva F, Perna G, Senni M, De Maria R
- Issue date: 2009 Jul