"It is truly a new inotrope, a drug that acts on the sarcomere itself. It does seem to be free of the nemesis of other inotropes: increased heart rate, greater myocardial oxygen consumption, arrhythmia production, and increased mortality in heart failure. It appears to be the Holy Grail, and may be capable of replacing dobutamine and milrinone," said Dr. McDonagh, professor of heart failure at King’s College London.
"I think this [ATOMIC-AHF trial] is a very promising start for omecamtiv mecarbil in acute heart failure," she added.
Since it also has negative chronotropic effect, one can speculate that it could possibly retire the use of b-blockers in HF too. How about in diastolic dysfunction? Anybody know if OM is also indicated in this population?
I think it's unlikely to be indicated for diastolic dysfunction, because the problem there is not the strength of the contractile mechanism. The problem is "stiffness" of the heart muscle, which does not allow it to relax and let the ventricle fill during its relaxation phase.