Acute and chronic heart failure are characterized by impaired cardiac contractile function (inotropy), leading to reduced cardiac output and end-organ hypoperfusion. Cardiotropic drugs, particularly inotropes, are a cornerstone of treatment in acute decompensated heart failure and cardiogenic shock, designed to directly enhance myocardial contractility. However, these agents possess a narrow therapeutic window and are associated with significant risks, including arrhythmogenesis, increased myocardial oxygen consumption, and potential long-term cardiotoxicity. A standardized, "one-size-fits-all" dosing approach fails to account for the vast inter-patient variability in pathophysiology, comorbidities, and pharmacodynamic response. Therefore, optimizing the individual dosage of these potent medications is a critical clinical challenge. This article explores the modern strategies for personalizing inotrope therapy, aiming to maximize hemodynamic benefits while minimizing adverse effects, thereby improving patient outcomes.

inotropes, heart failure, cardiac contractility, personalized medicine, hemodynamic monitoring, dose optimization, dobutamine, milrinone, cardiogenic shock.

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