Inotropes in chronic beta-blocker therapy

The increasing rate of cardiovascular disorders contributes to rising hospitalized patients receive chronic oral beta-blocker therapy. Beta-blockers remain one of the fundamental therapy for chronic heart failure. Still, their role in decompensated heart failure and severe sepsis during hospitalization is often debated and inconsistent in clinical practice. In recent years, evidence of the efficacy and clinical outcomes of beta-blockers in acute heart failure (AHF) have accumulated. Clinical research indicates that chronic beta-blockade withdrawals should be prevented, or as soon as hemodynamic stabilization and euvolemic condition are reached, it should be reinstituted. As a subset of AHF patients with low cardiac output required inotropes, the choice of proper agent is fundamental. Different inotropic agents such as inhibitors of the phosphodiesterase, levosimendan, and dobutamine also their associations with beta-blockers are discussed.