{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T20:10:49Z","timestamp":1769112649123,"version":"3.49.0"},"reference-count":17,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2018,11,10]]},"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The prognostic significance of transient use of inotropes has been sufficiently studied in recent heart failure (HF) populations. We hypothesised that risk stratification in these patients could contribute to patient selection for advanced therapies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analysed a prospective cohort of adult patients admitted with decompensated HF and ejection fraction (left ventricular ejection fraction (LVEF)) less than 50%. We explored the outcomes of patients requiring inotropic therapy during hospital admission and after discharge.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The study included 737 patients, (64.0% male), with a median age of 58 years (IQR 48\u201366 years). Main aetiologies were dilated cardiomyopathy in 273 (37.0%) patients, ischaemic heart disease in 195 (26.5%) patients and Chagas disease in 163 (22.1%) patients. Median LVEF was 26 % (IQR 22%\u201335%). Inotropes were used in 518 (70.3%) patients. In 431 (83.2%) patients, a single inotrope was administered. Inotropic therapy was associated with higher risk of in-hospital death\/urgent heart transplant (OR=10.628, 95% CI 5.055 to 22.344, p&lt;0.001). At 180-day follow-up, of the 431 patients discharged home, 39 (9.0%) died, 21 (4.9%) underwent transplantation and 183 (42.4%) were readmitted. Inotropes were not associated with outcome (death, transplant and rehospitalisation) after discharge.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Inotropic drugs are still widely used in patients with advanced decompensated HF and are associated with a worse in-hospital prognosis. In contrast with previous results, intermittent use of inotropes during hospitalisation did not determine a worse prognosis at 180-day follow-up. These data may add to prognostic evaluation in patients with advanced HF in centres where mechanical circulatory support is not broadly available.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2018-000923","type":"journal-article","created":{"date-parts":[[2018,12,6]],"date-time":"2018-12-06T12:58:12Z","timestamp":1544101092000},"page":"e000923","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Prognosis and risk stratification in patients with decompensated heart failure receiving inotropic therapy"],"prefix":"10.1136","volume":"5","author":[{"given":"Clara","family":"Gomes","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Centro Hospitalar de S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"given":"Ca\u00edque Bueno","family":"Terhoch","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor) do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}]},{"given":"Silvia Moreira","family":"Ayub-Ferreira","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor) do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}]},{"given":"Germano Emilio","family":"Concei\u00e7\u00e3o-Souza","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor) do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}]},{"given":"Vera Maria Cury","family":"Salemi","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor) do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}]},{"given":"Paulo Roberto","family":"Chizzola","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor) do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}]},{"given":"Mucio Tavares","family":"Oliveira Jr","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor) do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}]},{"given":"Silvia Helena Gelas","family":"Lage","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor) do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}]},{"given":"Fernando","family":"Frioes","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Centro Hospitalar de S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"given":"Edimar Alcides","family":"Bocchi","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor) do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9351-8949","authenticated-orcid":false,"given":"Victor Sarli","family":"Issa","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Centro Hospitalar de S\u00e3o Jo\u00e3o, Porto, Portugal"},{"name":"Heart Institute (InCor) do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}]}],"member":"239","published-online":{"date-parts":[[2018,12,6]]},"reference":[{"key":"2025081711034126000_5.2.e000923.1","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/j.amjcard.2017.05.028","article-title":"Etiologies, trends, and predictors of 30-day readmissions in patients with diastolic heart failure","volume":"120","author":"Arora","year":"2017","journal-title":"Am J Cardiol"},{"key":"2025081711034126000_5.2.e000923.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00309-7"},{"key":"2025081711034126000_5.2.e000923.3","doi-asserted-by":"crossref","first-page":"e0006207","DOI":"10.1371\/journal.pntd.0006207","article-title":"Clinical findings and prognosis of patients hospitalized for acute decompensated heart failure: Analysis of the influence of Chagas etiology and ventricular function","volume":"12","author":"Terhoch","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"2025081711034126000_5.2.e000923.4","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1016\/j.healun.2014.05.015","article-title":"Treatment with inotropes and related prognosis in acute heart failure: contemporary data from the Italian Network on Heart Failure (IN-HF) Outcome registry","volume":"33","author":"Mortara","year":"2014","journal-title":"J Heart Lung Transplant"},{"key":"2025081711034126000_5.2.e000923.5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.12.1541"},{"key":"2025081711034126000_5.2.e000923.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.03.051"},{"key":"2025081711034126000_5.2.e000923.7","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/s00392-016-0968-y","article-title":"Long-term intravenous inotropes in low-output terminal heart failure?","volume":"105","author":"von Scheidt","year":"2016","journal-title":"Clin Res Cardiol"},{"key":"2025081711034126000_5.2.e000923.8","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/ejhf.592","article-title":"ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"2016","author":"Ponikowski","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"2025081711034126000_5.2.e000923.9","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.114.001778"},{"key":"2025081711034126000_5.2.e000923.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-010-2113-0"},{"key":"2025081711034126000_5.2.e000923.11","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl193"},{"key":"2025081711034126000_5.2.e000923.12","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.18.2217"},{"key":"2025081711034126000_5.2.e000923.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2006.09.005"},{"key":"2025081711034126000_5.2.e000923.14","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1002\/phar.1939","article-title":"Effect of Inpatient Dobutamine versus Milrinone on Out-of-Hospital Mortality in Patients with Acute Decompensated Heart Failure","volume":"37","author":"King","year":"2017","journal-title":"Pharmacotherapy"},{"key":"2025081711034126000_5.2.e000923.15","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-010-2073-4"},{"key":"2025081711034126000_5.2.e000923.16","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1002\/ejhf.39","article-title":"Weaning from inotropic support and concomitant beta-blocker therapy in severely ill heart failure patients: take the time in order to improve prognosis","volume":"16","author":"Constantinescu","year":"2014","journal-title":"Eur J Heart Fail"},{"key":"2025081711034126000_5.2.e000923.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2014.05.006"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2018-000923","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T18:03:46Z","timestamp":1755453826000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2018-000923"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12]]},"references-count":17,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018,12,6]]},"published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1136\/openhrt-2018-000923"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2018-000923","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12]]}}}