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

[en] 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 Authors

Disciplines :

Cardiovascular & respiratory systems

Author, co-author :

Psotka, M. A.; Inova Heart and Vascular Institute, Falls Church, VA, United States

Gottlieb, S. S.; Department of Medicine, Division of Cardiovascular Medicine, University of Maryland School of Medicine, Baltimore, MD, United States

Francis, G. S.; Cardiovascular Division, University of Minnesota Medical School, Minneapolis, MN, United States

Allen, L. A.; Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States

Teerlink, J. R.; School of Medicine, University of California San Francisco and Section of Cardiology, San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States

Adams, K. F.; Jr., University of North Carolina School of Medicine, Chapel Hill, NC, United States

Rosano, G. M. C.; Cardiovascular Clinical Academic Group, St. George's Hospitals NHS Trust University of London, London, United Kingdom

Lancellotti, Patrizio ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation

Language :

English

Title :

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

Publication date :

2019

Journal title :

Journal of the American College of Cardiology

ISSN :

0735-1097

eISSN :

1558-3597

Publisher :

Elsevier USA

Volume :

Issue :

Pages :

2345-2353

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 27 August 2019

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134 (1 by ULiège)

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