Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jul 26, 2016; 8(7): 401-412
Published online Jul 26, 2016. doi: 10.4330/wjc.v8.i7.401
Novel role of phosphodiesterase inhibitors in the management of end-stage heart failure
Abhishek Jaiswal, Vinh Q Nguyen, Thierry H Le Jemtel, Keith C Ferdinand
Abhishek Jaiswal, Vinh Q Nguyen, Thierry H Le Jemtel, Keith C Ferdinand, Tulane School of Medicine, Tulane University Heart and Vascular Institute, New Orleans, LA 70112, United States
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest statement: Dr. Ferdinand is a consultant with Amgen, Boerhinger Ingelheim, Eli Lilly, Sanofi. All other authors report no relationships relevant to the contents of this paper to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Keith C Ferdinand, MD, Tulane School of Medicine, Tulane University Heart and Vascular Institute, 1430 Tulane Avenue, SL# 48, New Orleans, LA 70112, United States. kferdina@tulane.edu
Telephone: +1-504-9885492 Fax: +1-504-9884237
Received: February 26, 2016
Peer-review started: February 26, 2016
First decision: April 15, 2016
Revised: May 2, 2016
Accepted: May 31, 2016
Article in press: June 2, 2016
Published online: July 26, 2016
Processing time: 143 Days and 11.7 Hours
Core Tip

Core tip: Heart failure (HF) patients requiring chronic inotropic support are considered hemodynamically labile and may escape the benefits of evidence based HF therapy (HFTx). Chronic milrinone infusion may be beneficial as a bridge to introduction of HFTx. We discuss evidence that intravenous milrinone support may allow introduction of beta blocker (BB). We propose that HF patients who are intolerant to BB therapy may benefit from intravenous milrinone as a bridge to BB initiation. When used together, BB mitigates cardiotoxic effects and decreases the risk of arrhythmias associated with milrinone. Whereas, milrinone does not attenuate the clinical benefits of BB therapy.