Combination Therapy With Beta Blocker and Inotrope in Decompensated Heart Failure: A Clinical Observation

Abstract

Inotropic support is contemplated in the presence of ongoing end-organ hypoperfusion or 
refractory symptoms in decompensated heart failure (DHF). However, inotropic agents may 
cause tachycardia leading to increased myocardial oxygen demand and arrhythmogenesis.1
Introduction of beta blocker (BB) therapy in DHF patients requiring inotrope support is 
discouraged due to the negative hemodynamic impact of acute BB therapy.2-5 On the other 
hand, reduction in heart rate by BB therapy results in decreased myocardial oxygen demand 
and increased ventricular diastolic filling.6,7 Additionally, early introduction of BB therapy 
improves outcome in heart failure.2-5,8