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Levosimendan is a novel inotropic and vasodilator agent used in heart failure, whereas the impact of levosimendan on ventricular remodelling is still unclear. This study aims to investigate the impact of levosimendan on ventricular remodelling in patients with left ventricular systolic dysfunction. Electronic databases were searched to identify eligible studies. A total of 66 randomized controlled trials involving 7968 patients were included. Meta-analysis results showed that levosimendan increased left ventricular ejection fraction [mean difference (MD) = 3.62, 95% confidence interval (CI) (2.88, 4.35), P &amp;lt; 0.00001] and stroke volume [MD = 6.59, 95% CI (3.22, 9.96), P = 0.0001] and significantly reduced left ventricular end-systolic volume [standard mean difference (SMD) = \u22120.52, 95% CI (\u22120.67, \u22120.37), P &amp;lt; 0.00001], left ventricular end-diastolic volume index [SMD = \u22121.24, 95% CI (\u22121.61, \u22120.86), P &amp;lt; 0.00001], and left ventricular end-systolic volume index [SMD = \u22121.06, 95% CI (\u22121.43, \u22120.70), P &amp;lt; 0.00001]. In terms of biomarkers, levosimendan significantly reduced the level of brain natriuretic peptide [SMD = \u22121.08, 95% CI (\u22121.60, \u22120.56), P &amp;lt; 0.0001], N-terminal pro-brain natriuretic peptide [SMD = \u22120.99, 95% CI (\u22121.41, \u22120.56), P &amp;lt; 0.00001], and interleukin-6 [SMD = \u22120.61, 95% CI (\u22120.86, \u22120.35), P &amp;lt; 0.00001]. Meanwhile, levosimendan may increase the incidence of hypotension [risk ratio (RR) = 1.24, 95% CI (1.12, 1.39), P &amp;lt; 0.0001], hypokalaemia [RR = 1.57, 95% CI (1.08, 2.28), P = 0.02], headache [RR = 1.89, 95% CI (1.50, 2.39), P &amp;lt; 0.00001], atrial fibrillation [RR = 1.31, 95% CI (1.12, 1.52), P = 0.0005], and premature ventricular complexes [RR = 1.86, 95% CI (1.27, 2.72), P = 0.001]. In addition, levosimendan reduced all-cause mortality [RR = 0.83, 95% CI (0.74, 0.94), P = 0.002]. In conclusion, our study found that levosimendan might reverse ventricular remodelling when applied in patients with left ventricular systolic dysfunction, especially in patients undergoing cardiac surgery, decompensated heart failure, and septic shock.<\/jats:p>","DOI":"10.1002\/ehf2.14714","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T01:20:25Z","timestamp":1709169625000},"page":"1352-1376","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of Levosimendan on Ventricular Remodelling in Patients with Left Ventricular Systolic Dysfunction: A Meta-Analysis"],"prefix":"10.1093","volume":"11","author":[{"given":"Xia","family":"Wang","sequence":"first","affiliation":[{"name":"National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Department of Cardiology, Qilu Hospital of Shandong University \u00a0","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiu-Zhi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, People's Hospital of Lixia District of Jinan , Jinan, Shandong ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi-Wen","family":"Wang","sequence":"additional","affiliation":[{"name":"National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Department of Cardiology, Qilu Hospital of Shandong University \u00a0","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu-Ying","family":"Cao","sequence":"additional","affiliation":[{"name":"National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Department of Cardiology, Qilu Hospital of Shandong University \u00a0","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Lu","sequence":"additional","affiliation":[{"name":"National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Department of Cardiology, Qilu Hospital of Shandong University \u00a0","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi-Hao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Shandong Key Laboratory of Cardiovascular Proteomics, Qilu Hospital, Cheeloo College of Medicine, Shandong University , Jinan ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Department of Cardiology, Qilu Hospital of Shandong University \u00a0","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Ti","sequence":"additional","affiliation":[{"name":"National Key Laboratory for Innovation and 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