Heart failure & cardiomyopathies

The possible impact of levosimendan infusions on clinical course of heart failure: the results of the LEIA-HF study

ESC Heart FailPublished multicentre, randomized, double-blind, placebo-controlled, Phase IV clinical trial

  • prematurely terminated

Authors' conclusion

In a selected group of stable ambulatory advanced HF (left ventricular ejection fraction ≤35%, New York Heart Association Classes III and IV) patients, repetitive levosimendan 24 h infusion might be an additional therapeutic option but observed deaths may raise its safety issue.

Study context

Population
Patients with ambulatory stable advanced heart failure (HF) (left ventricular ejection fraction ≤35%, New York Heart Association Classes III and IV)out of 350 planned
Participants
64 patients
Comparison
Intermittent levosimendan vs placebo
  • Levosimendan group (study group)n = 34
  • Placebo groupn = 30
Primary endpoint
Death from any cause or unplanned hospitalization for HF, whichever occurred first
Follow-up
12-month follow-up period
Methodological detailsnine centres around Poland
  • Nine centres around Poland

Primary result

As reported in the abstract

P = 0.14

Further findings

N-terminal pro-B-type natriuretic peptide concentrations in the study group

Significant decrease
5084 pg/ml (306-23.203) vs 2027 pg/ml (872-2174), P = .02

Left ventricular ejection fraction in the study group

Improvement
20.9 ± 5.9% vs 29.27 ± 5.23%, P = .015

Study conduct

The study was prematurely terminated due to excess of deaths in the active treatment group

Safety

OutcomeLevosimendan group (study group)Placebo groupP value
DeathsSignificantly higher deaths with levosimendan100%0 eventsP = 0.02

Original publication

The possible impact of levosimendan infusions on clinical course of heart failure: the results of the LEIA-HF study. ESC Heart Fail. Published 16 January 2026. doi:10.1093/eschf/xvag021

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