Impaired cardiac contractility is a fundamental component of the heart failure syndrome,
initiating the cycle of vasoconstriction, neurohormonal and inflammatory activation, and
adverse ventricular remodeling that leads to heart failure progression. Based on this core
paradigm, drugs that increase cardiac contractility (positive inotropes) are theoretically
appealing as a heart failure therapy, and such agents have been extensively investigated in
both acute and chronic heart failure. Although these agents clearly improve cardiac output …