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Background <p>Levosimendan is a calcium sensitizer used for managing heart failure (HF) because of its inotropic and vasodilatory effects. Our objective was to analyze the feasibility and effectiveness of levosimendan infusion in hospitalized advanced-stage HF patients with acute decompensation and compare it with furosemide.</p> Methods <p>A total of 227 patients with left ventricular ejection fraction (LVEF) &lt; 40% were enrolled, including 116 receiving levosimendan/furosemide and 111 receiving furosemide. Demographic and laboratory parameters; age, sex, creatinine, estimated&#xa0;glomerular&#xa0;filtration&#xa0;rate&#xa0;(eGFR), and NT-proBNP levels were assessed in both groups at weeks 1, 3, and 9. Sodium, calcium, and uric acid levels were additionally compared at weeks 1 and 9.</p> Results <p>Both levosimendan/furosemide and furosemide groups showed a significant reduction in NT-pro-BNP levels over the 9-week follow-up (p &lt; 0.001). However, the furosemide group exhibited a significant increase in creatinine and uric acide (p &lt; 0.001). In patients receiving levosimendan/furosemide, LVEF values negatively influenced NT-pro-BNP levels across all quantiles, with this effect being particularly stronger at higher NT-proBNP levels (B = −&#xa0;432.09,&#xa0;<i>p</i> &lt; 0.05; B = −&#xa0;722.12,&#xa0;<i>p</i> &lt; 0.001; B = −&#xa0;833.68,&#xa0;<i>p</i> &lt; 0.001), whereas furosemide was effective only in the high NT-pro-BNP subgroup (B = −&#xa0;1128.26,&#xa0;<i>p</i> &lt; 0.05).</p> Conclusion <p>When the patients were divided into 3 groups according to their NT-pro-BNP levels, the effect of the drug was detected at all levels in the levosimendan/furosemide group. The findings demonstrated that levosimendan-treated patients with advanced HFrEF exhibited significantly reduced NT-proBNP levels relative to those receiving furosemide. As a result, we concluded that levosimendan had fewer side effects and was more useful.</p>

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Repeated Administiration of Levosimendan/Furosemide Infusion on NT-Pro-BNP Levels in Advanced Heart Failure

  • 期刊论文

  • 发表日期：

    2025年10月21日

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  • Musa Ilker Durak,
  • Beyza Algül Durak,
  • Naim Ata,
  • Mustafa Mahir Ülgü,
  • Şuayip Birinci

摘要

Background

Levosimendan is a calcium sensitizer used for managing heart failure (HF) because of its inotropic and vasodilatory effects. Our objective was to analyze the feasibility and effectiveness of levosimendan infusion in hospitalized advanced-stage HF patients with acute decompensation and compare it with furosemide.

Methods

A total of 227 patients with left ventricular ejection fraction (LVEF) < 40% were enrolled, including 116 receiving levosimendan/furosemide and 111 receiving furosemide. Demographic and laboratory parameters; age, sex, creatinine, estimated glomerular filtration rate (eGFR), and NT-proBNP levels were assessed in both groups at weeks 1, 3, and 9. Sodium, calcium, and uric acid levels were additionally compared at weeks 1 and 9.

Results

Both levosimendan/furosemide and furosemide groups showed a significant reduction in NT-pro-BNP levels over the 9-week follow-up (p < 0.001). However, the furosemide group exhibited a significant increase in creatinine and uric acide (p < 0.001). In patients receiving levosimendan/furosemide, LVEF values negatively influenced NT-pro-BNP levels across all quantiles, with this effect being particularly stronger at higher NT-proBNP levels (B = − 432.09, p < 0.05; B = − 722.12, p < 0.001; B = − 833.68, p < 0.001), whereas furosemide was effective only in the high NT-pro-BNP subgroup (B = − 1128.26, p < 0.05).

Conclusion

When the patients were divided into 3 groups according to their NT-pro-BNP levels, the effect of the drug was detected at all levels in the levosimendan/furosemide group. The findings demonstrated that levosimendan-treated patients with advanced HFrEF exhibited significantly reduced NT-proBNP levels relative to those receiving furosemide. As a result, we concluded that levosimendan had fewer side effects and was more useful.