This causes peripheral edema (blood pooling), which the sympathetic nervous system tries to correct[3] by overstimulating the cardiac myocytes, leading to left ventricular hypertrophy, another characteristic of chronic heart failure.

inotropic therapies work by increasing the force of cardiac contraction, such as through calcium conduction or modulating adrenoreceptors.

But these are limited by adverse events, including arrhythmias related to increased myocardial oxygen consumption, desensitization of adrenergic receptors, and altering intracellular calcium levels.

[2] Omecamtiv mecarbil effectively relieves symptoms and enhances the quality of life of systolic heart failure patients.

[16] The METEORIC-HF randomized clinical trial found that omecamtiv mecarbil does not significantly improve exercise capacity.

[17] Research groups found that omecamtiv mecarbil actually inhibits myosin by enhancing the duty ratio, increasing calcium sensitivity and slowing force development.