The value of positive inotropy in acute and chronic heart failure.

The different pathophysiological causes of acute and chronic heart failure prohibit a simple therapeutic approach with only one type of drug. Recent investigations have shown that the judicious use of positive inotropic agents, diuretics, and vasodilators in addition to dietary and exercise therapy can relieve the symptoms of heart failure and improve the quality of life as well as the prognosis. Apparently, the major breakthrough of modern treatment has not been the use of new or old positive inotropic drugs but rather the careful use of preload and afterload reducing agents. The proper place for beta-blocker therapy in chronic systolic or diastolic heart failure has not been established yet.