Henry Ford Hospital Medical Journal


Current therapy for heart failure remains inadequate. New positive inotropic agents that augment myocardial contractility have been introduced. The positive inotropic effects of these nonglycoside, nonsympathomimetic agents are due, at least in part, to inhibition of cardiac phosphodiesterase activity and hence to an increase in myocardial cyclic AMP levels. These agents also have vasodilator properties through their effects on the enzyme phosphodiesterase in the vascular smooth muscle. Recent developments in the preclinical pharmacology, mechanism of action, and clinical experience with these new inotrope vasodilators are presented in this review. The role these drugs will play in revising our therapeutic strategy in congestive heart failure remains to be defined.