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NCT07262723Not yet recruitingPhase 2/3

Levosimendan in Acute Decompensated Heart Failure

Efficacy and Safety of Levosimendan in Patients With Acute Decompensated Heart Failure: A Real-World Evidence

Source: ClinicalTrials.gov · Last updated 4 Dec 2025

Brief summary (registry, in English)

Acute decompensated heart failure (ADHF) is one of the major causes of hospitalization and mortality worldwide. Despite advances in medical treatments, managing ADHF remains complex, especially in high-risk populations. Levosimendan, a calcium sensitizer that improves myocardial contractility and reduces complications associated with acute decompensated heart failure, has shown potential in improving outcomes in these patients. The present study aims to evaluate the efficacy and safety of levosimendan in patients with ADHF in a real-world clinical setting. This pragmatic, multicenter, randomized, controlled trial will include adult patients diagnosed with ADHF in two groups: one receiving levosimendan infusion, and the other receiving standard care for heart failure management, according to the most up-to-date clinical protocols. The study is designed to assess both the efficacy and safety of levosimendan, comparing it with the current standard of care. The primary endpoint of the study will be a clinical composite outcome measured from the NYHA functional classification of heart failure and patient global assessment. Secondary endpoints will include change in serum pro-BNP levels, clinical outcome of heart failure, changes in dyspnea status, all-cause and cardiac mortality. Safety endpoints, including adverse events, will also be systematically recorded and analyzed. Adverse events will be closely monitored, categorized as either mild, moderate, or severe, and their potential association with the treatment will be assessed. Data collection will occur at baseline and during subsequent follow-up visits at 6 hours, 24 hours, 5 days (or day of discharge), and 90 days post-treatment. Key efficacy measures will be obtained through clinical evaluations and laboratory tests, including blood pressure, electrocardiogram (ECG) findings, and NT-proBNP serum levels. The statistical analysis will follow an intention-to-treat (ITT) and Per protocol (PP) approach to account for all enrolled patients, ensuring robust and generalizable findings. This study will be conducted in accordance with Good Clinical Practice (GCP) guidelines and ethical standards outlined in the Declaration of Helsinki, prioritizing participant safety and scientific rigor throughout the study. 12 The results of this trial will provide critical insights into the potential benefits of levosimendan for treating ADHF, and could potentially inform clinical decision-making, offering a more effective therapeutic option in managing this life-threatening condition.

Status (registry)
Not yet recruiting
Phase (registry)
Phase 2/3
Study type
Interventional
Enrollment
332 (estimated)
First submitted
23 Nov 2025
Start date
1 Dec 2025
Primary completion date
30 Oct 2026
Lead sponsor
Chittagong Medical College
NCT number
NCT07262723

What you commit to

  • Study type: Interventional · Phase 2/3
  • Planned participants: 332
  • From 1 Dec 2025 to the primary completion date, 30 Oct 2026
  • 6 sites in 1 country
  • Visits and tests: ask the trial team, the registry does not list them

Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.

Who cannot take part

Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.

Prior treatment

  • Angina within 6 h prior to screening
  • Respiratory (e.g. COPD exacerbation requiring systematic steroids or intubation)
  • Use of amrinone and milrinone prior to screening
  • Previous participation in a clinical trial with any experimental treatment within the last 30 days

Other illness

  • History of invasive cardiac procedure
    • Cardiac surgery during lifetime within 3 months prior to screening
    • Cardiac revascularization within 3 months prior to screening
    • Left ventricular assist device (LVAD) implantation within 3 months prior to screening
    • A cardioversion within 4 h prior to screening, or
    • Cardiac re-synchronization procedure within 30 days prior to screening)
  • Rhythm disorders (e.g. earlier Torsades de Pointes, increased heart rate)
  • CNS disease (e.g. stroke, TIA)
  • Hepatic impairment (e.g. significant increase in liver enzymes, \>5x the upper limit of normal)
  • Decompensation from active infection eg, sepsis
  • Acute bleeding
  • A history of hypersensitivity to levosimendan or any of the excipients

Lab values

  • Renal insufficiency (e.g. increased serum creatinine clearance rate \<15 mL/min)
  • Patient required blood transfusion or Severe anemia (hemoglobin \<8 g/l)
  • Serum potassium concentration \<3.5 or \>5.4 mmol/l

Other

  • Severe ventricular outflow obstruction
  • Hypotension (a systolic blood pressure \<90 mmHg) \[Can be included after resuscitation, when SBP will be \>90 mmHg by noradrenaline infusion\]
  • Uncorrected hypokalemia
  • Intubated or otherwise unable to communicate
  • Pregnancy
  • Post partum cardiomyopathy

Who the study is looking for

  • Adult patients (age \>18 years)
  • Both male and female sex
  • Having left ventricular dysfunction, evidenced by a left ventricular ejection fraction \<40% within the prior 12 months
  • Hospitalized for the treatment of ADHF
  • Remained dyspneic at rest despite treatment with intravenous diuretics (NYHA class IV)
  • Patients might have received intravenous vasodilators and/or positive inotropic drugs (except amrinone and milrinone), but the infusion rates of these drugs must have remained constant for at least 2 h before entry into the study.

Age in the registry: 18 years to - · Sex: All · Does not accept healthy volunteers

Full criteria on ClinicalTrials.gov

Sites (6)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
Chattogram Maa-O-Shishu Hospital Medical College Hospital
Coordinator of this site? Confirm its status
ChittagongBangladeshUnknown status
Chittagong Medical College Hospital, Chattogram
Coordinator of this site? Confirm its status
ChittagongBangladeshUnknown status
Apollo Imperial Hospital & Max Hospital
Coordinator of this site? Confirm its status
ChittagongBangladeshUnknown status
Cox's Bazar Medical College
Coordinator of this site? Confirm its status
Cox’s BāzārBangladeshUnknown status
National Institute of Cardiovascular Diseases
Coordinator of this site? Confirm its status
DhakaBangladeshUnknown status
United Hospital Limited
Coordinator of this site? Confirm its status
DhakaBangladeshUnknown status

This page is information, not medical advice. Discuss any trial with your doctor.