Table 1.

Narrative summaries of principal controlled trials of levosimendan in left-sided acute heart failure

In the LIDO study, levosimendan was compared with dobutamine in 203 patients with low-output heart failure who required right heart catheterization and treatment with an intravenous inotropic drug. Levosimendan was administered as a 24-h intravenous infusion at a rate of 0.1–0.2 µg/kg/min.16

The RUSSLAN study (N = 504) was primarily a safety evaluation of levosimendan in patients with left ventricular failure complicating an acute myocardial infarction.17 Patients randomized to levosimendan were treated with a 6-h intravenous infusion at a rate of 0.1–0.4 µg/kg/min. Invasive haemodynamics were not performed.

The SURVIVE study (N = 1327) compared the effects of levosimendan or dobutamine on mortality in patients with severe systolic heart failure. Levosimendan was infused at rates of 0.1–0.2 µg/kg/min for 24 h.18

The REVIVE studies (REVIVE I, n = 100; REVIVE II, n = 600) evaluated the efficacy of levosimendan on symptoms of acute heart failure based on a novel composite endpoint of clinically relevant measures expressed as ‘improved’, ‘unchanged’, or ‘worse’ during 5 days of observation. Levosimendan was administered as a 24-h intravenous infusion at a rate of 0.1–0.2 µg/kg/min. Both REVIVE studies were conducted mainly in the USA.12