# Home Inotropes in Advanced Heart Failure: A Practical Review

## TL;DR

This review discusses the use of home inotropic therapy to manage advanced heart failure when transplant or device options are not available.

## Contribution

The paper provides a practical review of current evidence and administration considerations for home inotropes in advanced heart failure.

## Key findings

- Home inotropes can improve quality of life and reduce hospitalizations in advanced heart failure patients.
- There is a need for further research to enhance therapeutic options and outcomes for these patients.

## Abstract

Advanced heart failure (AdHF) is a progressive condition with a high morbidity and mortality burden despite optimal medical therapy. Heart transplant (HT) and left ventricular assist device (LVAD) represent the only two life-prolonging options in AdHF. Unfortunately, only a minority of AdHF patients are eligible for these life-saving therapies, and even patients who are candidates for HT usually incur prolonged waiting list times. Intermittent or continuous home-based inotropic therapy offers a potential solution to improve quality of life, reduce recurrent hospitalizations, and maintain organ function, both for the stabilization of patients who are ultimately candidates for life-saving therapies and for palliative care in those without other therapeutic options. In this review, we summarize the current literature on the role of home inotropes in managing AdHF, emphasizing the current evidence on the most adopted agents, the practical considerations for their administration, and the possible different preferred utilization of these agents. Finally, we address gaps in the literature and outline future research directions to enhance therapeutic options and outcomes.