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. 2025 Jul 17:13:20503121251357357.
doi: 10.1177/20503121251357357. eCollection 2025.

Survival differences according to baseline characteristics of patient with advanced heart failure treated with levosimendan

Angel-Alberto Garcia-Peña  1 , Alejandro Mariño  1 , Oscar-Mauricio Muñoz-Velandia  2 , Daniela Saa-González  2
Affiliations

Survival differences according to baseline characteristics of patient with advanced heart failure treated with levosimendan

Angel-Alberto Garcia-Peña et al. SAGE Open Med. .

Abstract

Aims: To assess whether baseline characteristics (age, New York Heart Association functional class, left ventricular ejection fraction, glomerular filtration rate, systolic blood pressure, and N-terminal pro-brain natriuretic peptide) predicted different survival functions in patients with advanced heart failure, treated with intermittent inotropics.

Methods: Survival analysis based on a retrospective cohort of patients with advanced heart failure, treated with intermittent infusion of levosimendan and managed at heart failure clinic of the Hospital Universitario San Ignacio, in Bogotá (Colombia). We evaluated which baseline characteristics were associated with worse survival outcomes, using Kaplan-Meier curves and log rank test.

Results: Forty-two patients with advanced heart failure were included (mean age: 69.5 ± 13.2 years, 97.6% New York Heart Association III-IV, 54.7% of the population had quadruple therapy). A total of 39.5% died during 1-year follow-up. Survival functions were worse in patients with N-terminal pro-brain natriuretic peptide levels >6000 pg/mL (HR: 2.72; 95% CI: 1.01-8.01, p = 0.0493). In contrast, no significant difference in mortality was found for those with basal GFR <60 versus ⩾60 ml/min (p = 0.1030), left ventricular ejection fraction ⩽20% versus >20% (p = 0.1040), systolic blood pressure <90 mmHg versus ⩾90 mmHg (p = 0.2463), according to functional class (p = 0.840) or age > 65 years (p = 0.169). A significant increase of left ventricular ejection fraction measurements was observed in 26 surviving patients at 12 months of follow-up (20% vs 34%, p < 0.0001).

Conclusion: Our preliminary data suggest that the only characteristic that could predict worse survival in patients with advanced heart failure treated with levosimendan is N-terminal pro-brain natriuretic peptide levels greater than 6000 pg/ml. Future research is needed to confirm our findings.

Keywords: Advanced heart failure; NT pro-BNP; functional class and left ventricular ejection fraction; levosimendan; mortality.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Kaplan-Meier survival curves according to NT pro-BNP levels.
Figure 1.
Kaplan–Meier survival curves according to NT pro-BNP levels. NT pro-BNP: N-terminal pro-brain natriuretic peptide.
Kaplan-Meier survival curves according to glomerular filtration rate.
Figure 2.
Kaplan–Meier survival curves according to glomerular filtration rate. GFR: glomerular filtration rate (ml/min/1.73 m2).
Kaplan—Meier survival curve as per different patients and survival rates.
Figure 3.
Kaplan–Meier survival curves according to LVEF. LVEF: left ventricular ejection fraction.
See this image and copyright information in PMC

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