SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Cardiac Calcitropes, Myotropes, and Mitotropes: JACC Review Topic of the Week.

Psotka, MA; Gottlieb, SS; Francis, GS; Allen, LA; Teerlink, JR; Adams, KF; Rosano, GMC; Lancellotti, P (2019) Cardiac Calcitropes, Myotropes, and Mitotropes: JACC Review Topic of the Week. J Am Coll Cardiol, 73 (18). pp. 2345-2353. ISSN 1558-3597 https://doi.org/10.1016/j.jacc.2019.02.051
SGUL Authors: Rosano, Giuseppe Massimo Claudio

[img]
Preview
PDF Published Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (1MB) | Preview

Abstract

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.

Item Type: Article
Additional Information: © 2019 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: cardiac contractility, heart failure, inotrope, systolic function, 1102 Cardiovascular Medicine And Haematology, 1117 Public Health And Health Services, Cardiovascular System & Hematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: J Am Coll Cardiol
ISSN: 1558-3597
Language: eng
Dates:
DateEvent
14 May 2019Published
6 May 2019Published Online
12 February 2019Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
PubMed ID: 31072579
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/111194
Publisher's version: https://doi.org/10.1016/j.jacc.2019.02.051

Actions (login required)

Edit Item Edit Item