Heart failure & cardiomyopathiesCohort study
Clinical and echocardiographic changes after intermittent levosimendan infusion in patients with advanced heart failure
- prospective, multicentre, observational study
Authors' conclusion
In patients with AdHF, intermittent levosimendan infusion resulted in early improvements in NT-proBNP levels and biventricular function, which tended to wane by 30 days. Early enhancements in LVGLS and RVFWLS were independently associated with better clinical outcomes, suggesting their potential role as markers to guide patient selection and therapeutic response.
Study context
- Population
- Patients with advanced heart failure (AdHF) treated with intermittent levosimendan infusion (12.5 mg at a rate of 0.1 μg/kg/min, without a bolus)patients with AdHF included
- Participants
- 37 patients
- Exposure
- Clinical, laboratory and echocardiographic assessments at baseline, 48 h, and 30 days post-infusion
- Levosimendann = 37
- Outcome
- Clinical and cardiac structure and function changes
- Follow-up
- First 30 days after levosimendan infusion (baseline vs 48 h vs 30 days)
Main finding
As reported in the abstract
- Mean arterial pressure (baseline vs 48 h vs 30 days)
- 81.3 ± 9.5 mmHg vs 80.9 ± 7.7 mmHg vs 79.1 ± 6.9 mmHg, P-value for trend = .079
- NT-proBNP (baseline vs 48 h vs 30 days)
- 1802 (1127-4436) ng/l to 1060 (830-3864) ng/l at 48 h and 1661 (1015-4245) ng/l at 30 days, P-value for trend = .006
- Left ventricular (LV) ejection fraction
- 30.9 ± 11.3% vs 32.2 ± 11.2%, vs 30.9 ± 11.3%, P-value for trend = .001
- LV global longitudinal strain
- −8.0 ± 3.5% vs −9.2 ± 3.5% vs −8.0 ± 3.3%, P-value for trend < .001
- Tricuspid annular plane systolic excursion
- 16.9 ± 3.1 mm vs 17.7 ± 3.4 vs 17.0 ± 3.5, P-value for trend .007
- Systolic pulmonary artery pressure
- 48.7 ± 15.8 mmHg vs 41.6 ± 12.7 mmHg vs 46.1 ± 15.0, P-value for trend <.001
Observational data: associations, not effects.
Secondary outcomes
Composite of decompensated HF, urgent HF rehospitalization, cardiogenic shock, cardiac arrest, and cardiovascular death (CV events) · 6 months
| Comparison | Values | adjusted OR (95% CI) | P value | |
|---|---|---|---|---|
| ΔLV global longitudinal strain (GLS) after 48 h · associated with a lower risk of events · secondary outcome · after accounting for confounders | Levosimendan 45.9% | 0.26 (0.10–0.67) | P = 0.006 | |
| ΔRV free wall longitudinal strain (FWLS) · associated with a lower risk of events · secondary outcome · after accounting for confounders | 0.75 (0.57–0.99) | P = 0.041 | ||
| 0.10.31310Adjusted odds ratio (log scale) |
Original publication
Clinical and echocardiographic changes after intermittent levosimendan infusion in patients with advanced heart failure. ESC Heart Fail. Published 13 January 2026. doi:10.1093/eschf/xvag017
Summarised from the published abstract; every number is checked against it