ReviewEuropean journal of heart failure2019
Why has positive inotropy failed in chronic heart failure? Lessons from prior inotrope trials.
Review in European journal of heart failure, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
59 citing papers in PubMed, 1 synthesis or guideline pooled it, 114 citations in OpenAlex.
- The quantitative haemodynamic effect of levosimendan, dobutamine, and milrinone in heart failure patients: a meta-analysis.ESC heart failure · 2026Pooled it
- An experimental medicine protocol for exploring the haemodynamic effects of dual agonism at the glucagon-like peptide-1 and glucagon receptor in healthy subjects.British journal of clinical pharmacology · 2026Trial
- Effects of danicamtiv, a novel cardiac myosin activator, in heart failure with reduced ejection fraction: experimental data and clinical results from a phase 2a trial.European journal of heart failure · 2020Trial
- Substrate-Dependent Pro- and Antiarrhythmic Action of Omecamtiv Mecarbil at the Ventricular and Atrial Level: Insights from a Langendorff-Perfused Rabbit Heart Model.Cardiovascular toxicology · 2026Article
- Digoxin Dosing Errors, Drug Interactions and Off-Label Risks: Insights from an EudraVigilance Disproportionality Analysis.Journal of clinical medicine · 2026Article
- Istaroxime in Acute Heart Failure and Early Cardiogenic Shock: A Calcium-Cycling Approach to Inotropic Therapy.International journal of molecular sciences · 2026Review
- Cardiac contractility modulation in heart failure management: unraveling molecular mechanisms to improve patient selection in heart failure management.Heart failure reviews · 2026Review
- Zhenwu Decoction Attenuates Water-Retention-Related Phenotypes and Multiorgan Injury in Rats With Doxorubicin-Induced Chronic Heart Failure.Cardiovascular therapeutics · 2026Article
- RRAD-reduction reveals efficacy of targeting L-type calcium channel regulation for treatment of heart failure.Cardiovascular research · 2025Article
- Comparative mechanistic analysis of danicamtiv and omecamtiv mecarbil's in vivo cardiac effects.The Journal of general physiology · 2025Article
- Establishing a context of use for three-dimensional cardiac tissue derived from human-induced pluripotent stem cell-derived cardiomyocytes using inotropes.Toxicological sciences : an official journal of the Society of Toxicology · 2025Article
- Review
- The effects of SGLT2i on cardiac metabolism in patients with HFpEF: Fact or fiction?Cardiovascular diabetology · 2025Review
- Trials and tribulations of cell therapy for heart failure: an update on ongoing trials.Nature reviews. Cardiology · 2025Review
- Omecamtiv mecarbil, a cardiac myosin activator with potential efficacy in heart failure.Archives of medical sciences. Atherosclerotic diseases · 2025Article
- Adeno-associated virus-mediated gene delivery ofAmerican journal of physiology. Heart and circulatory physiology · 2024Article
- Beyond quadruple therapy: the potential roles for ivabradine, vericiguat, and omecamtiv mecarbil in the therapeutic armamentarium.Heart failure reviews · 2024Review
- Home inotrope therapy in chronic stimulant-induced cardiomyopathy: a case series.European heart journal. Case reports · 2024Article
- Profiling the Biomechanical Responses to Workload on the Human Myocyte to Explore the Concept of Myocardial Fatigue and Reversibility: Rationale and Design of the POWER Heart Failure Study.Journal of cardiovascular translational research · 2024Article
- Phosphodiesterase in heart and vessels: from physiology to diseases.Physiological reviews · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 7 institutions in 3 countries.
Funding
Abstract
Current pharmacological therapies for heart failure with reduced ejection fraction are largely either repurposed anti-hypertensives that blunt overactivation of the neurohormonal system or diuretics that decrease congestion. However, they do not address the symptoms of heart failure that result from reductions in cardiac output and reserve. Over the last few decades, numerous attempts have been made to develop and test positive cardiac inotropes that improve cardiac haemodynamics. However, definitive clinical trials have failed to show a survival benefit. As a result, no positive inotrope is currently approved for long-term use in heart failure. The focus of this state-of-the-art review is to revisit prior clinical trials and to understand the causes for their findings. Using the learnings from those experiences, we propose a framework for future trials of such agents that maximizes their potential for success. This includes enriching the trials with patients who are most likely to derive benefit, using biomarkers and imaging in trial design and execution, evaluating efficacy based on a wider range of intermediate phenotypes, and collecting detailed data on functional status and quality of life. With a rapidly growing population of patients with advanced heart failure, the epidemiologic insignificance of heart transplantation as a therapeutic intervention, and both the cost and morbidity associated with ventricular assist devices, there is an enormous potential for positive inotropic therapies to impact the outcomes that matter most to patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.