Simdax (levosimendan IV) / AbbVie, Orion Corp, Tenax Therap - LARVOL DELTA

TNX-103-07: LEVEL-2: LEVosimendan to Improve Exercise Limitation in Patients With PH-HFpEF-2 (clinicaltrialsregister.eu) - P2/3 | N=116 | Not yet recruiting | Sponsor: Tenax Therapeutics Inc.

New P2/3 trial • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypertension • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

Inotropic therapy in outpatients with worsening or advanced heart failure: literature evidence and comparison of Italian management models (PubMed, G Ital Cardiol (Rome)) - "In this review, we explore the role of home-administered inotropes, specifically dobutamine, milrinone, dopamine, and levosimendan, in the management of AdvHF patients through a summary of current literature and the presentation of management models adopted in selected Italian centers. Reported experiences suggest improved quality of life, reduced hospital admissions, and enhanced clinical stability in patients with AdvHF. These models may serve as practical examples for organizing care pathways in a clinical context that remains poorly defined by current guidelines."

Clinical • Journal • Review • Cardiovascular • Congestive Heart Failure • Heart Failure • Palliative care • Transplantation

Levosimendan and dobutamine in sepsis induced cardiac dysfunction: when pharmacological elegance meets clinical complexity. (PubMed, Eur J Clin Pharmacol) - No abstract available

Journal • Infectious Disease • Septic Shock

Effect of Inotropes in Patients with Advanced Heart Failure: A Meta-Analysis of Randomized Trials. (PubMed, Tunis Med) - "Inotropic agents showed a non-significant trend toward reduced mortality in AHF patients. Heterogeneity limits firm conclusions. Larger RCTs are needed to identify subgroups that may benefit."

Clinical • Journal • Retrospective data • Review • Cardiovascular • Congestive Heart Failure • Heart Failure • Nephrology

Efficacy of Levosimendan for Sepsis-Induced Myocardial Dysfunction: A Bayesian Network Meta-Analysis (SCCM 2026) - "Levosimendan at 0.2 mcg/kg/min reduces mortality, lactic acid levels, and heart rate while improving cardiac index, LVEF, and stroke volume index in SIMD patients compared to dobutamine. These results suggest levosimendan is a superior inotropic agent, though more large-scale trials are needed to confirm these findings."

Retrospective data • Cardiovascular • Infectious Disease • Septic Shock

LEVEL-2: LEVosimendan to Improve Exercise Limitation in Patients With PH-HFpEF-2 (clinicaltrials.gov) - P3 | N=540 | Recruiting | Sponsor: Tenax Therapeutics, Inc. | Initiation date: Dec 2025 ➔ Mar 2026

Trial initiation date • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypertension • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

A RECURRENT CASE OF TAKOTSUBO CARDIOMYOPATHY (ACC 2026) - "She progressed to cardiogenic shock (SCAI D) and improved after 24-hour levosimendan infusion... Recurrent TC is not uncommon and may present with life-threatening complications. Early recognition, supportive therapy, and close follow-up are essential, while effective pharmacologic prevention remains uncertain."

Clinical • Acute Coronary Syndrome • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Endocrine Disorders • Gastroenterology • Heart Failure

CARDIAC SAFETY OF CHIMERIC ANTIGEN RECEPTOR (CAR) T CELL THERAPY IN CHILDREN: A SINGLE CENTER EXPERIENCE (EBMT 2026) - "All patients received a lymphodepleting regimen based on cyclophosphamide and fludarabine Mean age was 12±7.3yrs; all patients (62% boys) had normal baseline cardiac function and no signs of pericardial effusion...Signs of overt heart failure, associated with severe reduction in LV ejection fraction at week 2 (mean EF change -23±8%), developed in 4 patients, who needed additional inotropic support (Levosimendan)... Incident cardiac dysfunction in children undergoing CAR T-cell therapy is associated with CRS and type of CAR T cells infused. GLS may be more sensible than EF to screen patients at risk for cardiac events. Our data suggest that in children, mild cardiac dysfunction is frequent after CART-cell therapy, while causing symptomatic heart failure in a minority of patients (3.5%)."

Clinical • Cardiovascular • Congestive Heart Failure • Heart Failure

CARDIAC SAFETY OF CHIMERIC ANTIGEN RECEPTOR (CAR) T CELL THERAPY IN CHILDREN: A SINGLE CENTER EXPERIENCE (EBMT 2026) - "All patients received a lymphodepleting regimen based on cyclophosphamide and fludarabine Mean age was 12±7.3yrs; all patients (62% boys) had normal baseline cardiac function and no signs of pericardial effusion...Signs of overt heart failure, associated with severe reduction in LV ejection fraction at week 2 (mean EF change -23±8%), developed in 4 patients, who needed additional inotropic support (Levosimendan)... Incident cardiac dysfunction in children undergoing CAR T-cell therapy is associated with CRS and type of CAR T cells infused. GLS may be more sensible than EF to screen patients at risk for cardiac events. Our data suggest that in children, mild cardiac dysfunction is frequent after CART-cell therapy, while causing symptomatic heart failure in a minority of patients (3.5%)."

Clinical • Cardiovascular • Congestive Heart Failure • Heart Failure

Targeting disease biology in peripartum cardiomyopathy: rethinking support in cardiogenic shock? (PubMed, Eur J Heart Fail) - No abstract available

Journal • Cardiomyopathy • Cardiovascular

Pulmonary Hypertension Associated With Left Heart Disease: Challenges, Emerging Strategies, and Future Directions. (PubMed, J Am Coll Cardiol) - "Multiple pharmacologic agents, such as sotatercept, relaxin analogues, and levosimendan, along with device-based strategies such as pulmonary artery denervation, transcatheter atrial shunts, and pericardiotomy, are under investigation. Progress in clinical trials has been hindered by patient recruitment, phenotypic heterogeneity, and a lack of standardized functional and hemodynamic outcomes. This review summarizes the current knowledge on PH-LHD, highlights emerging pharmacologic and invasive therapies, discusses barriers to trial design and regulatory approval, and proposes a framework to guide future investigations."

Journal • Review • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypertension • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

Clinical practice in using corticosteroids and adjunctive sepsis therapies at the bedside among European ICUs: an ESICM-endorsed survey. (PubMed, Intensive Care Med Exp) - "Adjunctive therapies are widely used in European ICUs, particularly in patients with severe or refractory sepsis, despite limited supporting evidence. The substantial variability in practice highlights ongoing clinical uncertainty and underscores the need for well-designed randomized trials to inform evidence-based and individualized treatment strategies."

Journal • Anesthesia • Critical care • Hematological Disorders • Immunology • Infectious Disease • Septic Shock

Milrinone and levosimendan improve microvascular perfusion in septic rats: a randomized, placebo-controlled trial. (PubMed, Intensive Care Med Exp) - "In experimental abdominal sepsis, milrinone and levosimendan increase colonic and hepatic microvascular blood flow without affecting mitochondrial respiration. Adjunctive vasopressin alters hepatic but not colonic microvascular responses during combined inotropic therapy."

Journal • Preclinical • Gastrointestinal Disorder • Infectious Disease • Inflammation • Septic Shock

The potential effect of calcium sensitizer in pulmonary hypertension post-coronavirus disease-19 infection in presumptive familial dilated cardiomyopathy: a case report. (PubMed, J Med Case Rep) - "Managing advanced heart failure with mixed-type pulmonary hypertension. Following coronavirus disease-19 infection remains a complex clinical challenge. This case contributes to the growing evidence supporting the potential role of levosimendan as adjunctive therapy in managing post-coronavirus disease mixed-type pulmonary hypertension with intractable congestion and biventricular failure."

Journal • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypertension • Infectious Disease • Novel Coronavirus Disease • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

Clinical and Echocardiographic Effects of Vericiguat Therapy in Advanced Heart Failure Patients Undergoing LVAD Support (ISHLT 2026) - "Patients with recent LVAD implantation (<6 months), recent levosimendan therapy (<1 month), renal replacement therapy, or sildenafil use were excluded. Echocardiographically, LVEDD (59 ± 12 vs. 57 ± 8 mm; P = 0.68) and LVEF (22 ± 7 vs. 24 ± 5%; P = 0.56) were unchanged, but TAPSE improved (1.1 ± 0.3 vs. 1.5 ± 0.4 cm; P = 0.04) and RV FAC showed a trend toward improvement (34 ± 10 vs. 42 ± 9%; P = 0.08). No adverse events, hypotension, arrhythmias, or HF worsening occurred.Conclusion Vericiguat therapy was safe and improved right ventricular function in advanced HF patients on durable LVAD support, potentially addressing an important unmet therapeutic need in the medical management of late right ventricular dysfunction in this population."

Clinical • Metastases • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypotension

Early cardiac rehabilitation supported by levosimendan infusion and mitral valve repair in acute myocardial infarction complicated by cardiogenic shock. (PubMed, Int J Cardiol Cardiovasc Risk Prev) - "Via a strong collaboration between a tertiary cardiac centre and rehabilitation facility, recurrent decompensation was treated with early administration of ino-dilators, mitral transcatheter edge-to-edge repair (M-TEER) and a tailored cardiac rehabilitation programme, providing net improvement in clinical stability, functional capacity and subsequent clinical outcomes. This case highlights the potential role of early haemodynamic stabilization with levosimendan, M-TEER and multidisciplinary rehabilitation in improving functional outcomes, even in high-risk elderly patients with STEMI complicated by cardiogenic shock and severely reduced LVEF."

Journal • Cardiovascular • Myocardial Infarction

Cardiogenic shock complicating peripartum cardiomyopathy benefits from combination therapy with levosimendan and bromocriptine. (PubMed, Eur J Heart Fail) - "Thus, the combination therapy with LS and BR seems to be a safe and potentially beneficial therapeutic concept for the treatment of PPCM patients with CS. As experimental PPCM mouse data suggest that treatment of PPCM patients in CS with LS alone may worsen cardiac function by enhancing the PRL/PAI-1-dependent pathomechanism, treatment of LS in PPCM patients should always be accompanied by BR treatment."

Journal • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Fibrosis • Heart Failure • Immunology • SMAD2 • STAT3

Effect of levosimendan treatment in cardiac surgery: a network meta-analysis of randomized controlled trials. (PubMed, Front Cardiovasc Med) - "Moreover, prior meta-analyses have predominantly used pairwise comparisons and have not systematically compared levosimendan with all major inotropic alternatives (e.g., dobutamine, milrinone, and standard therapy) across multiple clinically relevant outcomes. Levosimendan improved postoperative hemodynamic parameters, showing a higher cardiac index than placebo and shorter ICU stays than dobutamine, but it did not provide significant renal protection as assessed by creatinine levels. https://www.crd.york.ac.uk/PROSPERO/recorddashboard, identifier CRD42024612151."

Journal • Retrospective data • Review • Cardiovascular • Congestive Heart Failure • Critical care • Heart Failure

Comparative Efficacy and Safety of Vasopressors and Inotropes in Acute Myocardial Infarction-Related Cardiogenic Shock: A Systematic Review and Network Meta Analysis of Randomized and Observational Studies. (PubMed, Cureus) - "Electronic databases were searched from inception to December 2025 for randomized controlled trials (RCTs) and observational studies that compared norepinephrine, epinephrine, dopamine, dobutamine, milrinone, and levosimendan. Norepinephrine is the preferred vasopressor due to its safety profile; however, the choice of inotrope between milrinone and dobutamine should be guided by patient physiology rather than survival expectations. Future research requires large-scale trials to detect modest mortality benefits in patients with diabetes."

Journal • Observational data • Retrospective data • Review • Cardiovascular • Diabetes • Metabolic Disorders • Myocardial Infarction

Ventricular remodeling phenotypes following intermittent levosimendan therapy in advanced heart failure (HEART FAILURE 2026) - No abstract available

Metastases • Cardiovascular • Congestive Heart Failure • Heart Failure

Early effects of levosimendan on LV function in patients with CCS and single vessel CTO of the LAD artery (HEART FAILURE 2026) - No abstract available

Clinical • Cardiovascular • Congestive Heart Failure • Heart Failure

Clinical outcomes of intermittent or outpatient intravenous levosimendan therapy in advanced chronic heart failure: a systematic review (HEART FAILURE 2026) - No abstract available

Clinical • Clinical data • Metastases • Review • Cardiovascular • Congestive Heart Failure • Heart Failure

Heart-mind interactions in advanced heart failure treated with intermittent levosimendan (HEART FAILURE 2026) - No abstract available

Metastases • Cardiovascular • Congestive Heart Failure • Heart Failure

Prognostic performance of the LEVO-D score in advanced heart failure patients treated with intermittent ambulatory levosimendan (HEART FAILURE 2026) - No abstract available

Clinical • Metastases • Cardiovascular • Congestive Heart Failure • Heart Failure

Levosimendan in acute myocardial infarction after percutaneous coronary intervention: a systematic review and meta-analysis with trial sequential analysis (HEART FAILURE 2026) - No abstract available

Retrospective data • Review • Cardiovascular • Myocardial Infarction