Tamargo Menéndez, JuanCaballero Collado, RicardoGómez García, RicardoBarana, AdrianaAmorós, IreneDelpón Mosquera, María Eva2025-10-292025-10-292009-09Tamargo, Juan, et al. «Investigational Positive Inotropic Agents for Acute Heart Failure». Cardiovascular & Hematological Disorders-Drug Targets, vol. 9, n.o 3, pp. 193-205. www.eurekaselect.com, https://doi.org/10.2174/187152909789007070.1871-529X10.2174/187152909789007070https://hdl.handle.net/20.500.14352/125493Acute heart failure represents a major public health problem due to its high prevalence, high rates of mortality and readmissions and significant healthcare costs. Patients with AHF and low cardiac output represent a small subgroup of patients with very high mortality rates that require inotropic support to improve cardiac systolic function. Classical inotropic agents, such as beta1-adrenergic agonists (dobutamine, dopamine) and phosphodiesterase III inhibitors (milrinone, enoximone) improve symptoms and hemodynamics by increasing free intracellular Ca(2+) levels, but also increase myocardial O(2) demands and exert arrhythmogenic effects. These actions explain why these drugs increase both short- and long-term mortality, particularly in patients with AHF and coronary artery disease. Thus, we need new inotropic agents that do not increase cytosolic Ca(2+) or myocardial oxygen demands or produce arrhythmogenesis for the treatment of high-risk patients with acute heart failure and low cardiac output. This review describes three new classes of investigational agents: levosimendan, a calcium sensitizer and potassium channel opener, istaroxime, the first new luso-inotropic agent and cardiac myosin activators.engjournal article2212-4063https://doi.org/10.2174/18715290978900707019534658https://www.eurekaselect.com/article/14848restricted access615.01/.03Inotropic drugsacute heart failurelevosimendanistaroximeCK-1827452Farmacología (Medicina)3209 Farmacología