{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T18:22:46Z","timestamp":1770834166606,"version":"3.50.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>To evaluate the short-term clinical, structural, and functional cardiac changes following intermittent levosimendan infusion and their prognostic implications in patients with advanced heart failure (AdHF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective, multicentre, observational study, patients with AdHF treated with intermittent levosimendan infusion (12.5\u2005mg at a rate of 0.1\u2005\u03bcg\/kg\/min, without a bolus) were enrolled. Clinical, laboratory, and comprehensive echocardiographic assessments were performed at baseline, 48\u2005h, and 30 days post-infusion. The primary endpoint was to evaluate the extent of clinical and cardiac structure and function changes during the first 30 days after levosimendan infusion. Secondary outcome of interest was the association of cardiac changes and a composite endpoint of decompensated HF, urgent HF rehospitalization, cardiogenic shock, cardiac arrest, and cardiovascular death at 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 37 patients with AdHF were included (mean age 71.1 \u00b1 9.0 years; 59.5% male). A non-significant trend reduction in mean arterial pressure values was observed over time (81.3 \u00b1 9.5\u2005mmHg vs 80.9 \u00b1 7.7\u2005mmHg after 48\u2005h vs 79.1 \u00b1 6.9\u2005mmHg at 30 days, P-value for trend = .079). NT-proBNP levels significantly decreased at 48\u2005h and rose again by 30 days [from 1802 (1127\u20134436) ng\/l to 1060 (830\u20133864) ng\/l at 48\u2005h and 1661 (1015\u20134245) ng\/l at 30 days, P-value for trend = .006]. The main left ventricular (LV) and right ventricular (RV) structure and function parameters improved at 48\u2005h but returned to baseline or a slight improvement by 30 days (LV ejection fraction: 30.9 \u00b1 11.3% vs 32.2 \u00b1 11.2%, vs 30.9 \u00b1 11.3%, P-value for trend = .001; LV global longitudinal strain: \u22128.0 \u00b1 3.5% vs \u22129.2 \u00b1 3.5% vs \u22128.0 \u00b1 3.3%, P-value for trend &amp;lt; .001; tricuspid annular plane systolic excursion: 16.9 \u00b1 3.1\u2005mm vs 17.7 \u00b1 3.4 vs 17.0 \u00b1 3.5, P-value for trend .007; systolic pulmonary artery pressure: 48.7 \u00b1 15.8\u2005mmHg vs 41.6 \u00b1 12.7\u2005mmHg vs 46.1 \u00b1 15.0, P-value for trend &amp;lt;.001). Overall, 17 (45.9%) patients experienced CV events. After accounting for confounders, \u0394LV global longitudinal strain (GLS) after 48\u2005h (adjusted odds ratio (OR) 0.26, 95% confidence interval (CI) 0.10\u20130.67, P = .006) and \u0394RV free wall longitudinal strain (FWLS) (adjusted OR 0.75, 95% CI 0.57\u20130.99, P = .041) were significantly associated with a lower risk of events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with AdHF, intermittent levosimendan infusion resulted in early improvements in NT-proBNP levels and biventricular function, which tended to wane by 30 days. Early enhancements in LVGLS and RVFWLS were independently associated with better clinical outcomes, suggesting their potential role as markers to guide patient selection and therapeutic response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag017","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T12:34:52Z","timestamp":1768048492000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical and echocardiographic changes after intermittent levosimendan infusion in patients with advanced heart failure"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3444-1916","authenticated-orcid":false,"given":"Mauro","family":"Riccardi","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Institute of Cardiology, University of Brescia, Spedali Civili di Brescia , Brescia ,","place":["Italy"]},{"name":"Division of 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,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Bisegna","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Institute of Cardiology, University of Brescia, Spedali Civili di Brescia , Brescia ,","place":["Italy"]},{"name":"Cardiologia, Ospedale Maggiore , Lodi ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Giulia","family":"Bellicini","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Institute of Cardiology, University of Brescia, Spedali Civili di Brescia , Brescia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9298-7871","authenticated-orcid":false,"given":"Matteo","family":"Pagnesi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Institute of Cardiology, University of Brescia, Spedali Civili di Brescia , Brescia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Savina","family":"Nodari","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Institute of Cardiology, University of Brescia, Spedali Civili di Brescia , Brescia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Pini","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Fondazione IRCCS San Gerardo dei Tintori , Monza ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato M","family":"Bragato","sequence":"additional","affiliation":[{"name":"Humanitas Research Hospital IRCCS, Rozzano , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5502-7882","authenticated-orcid":false,"given":"Michele","family":"Senni","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Papa Giovanni XXIII Hospital , Bergamo ,","place":["Italy"]},{"name":"Department of Cardiovascular Medicine, University Bicocca Milan , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo M","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Institute of Cardiology, University of Brescia, Spedali Civili di Brescia , Brescia ,","place":["Italy"]},{"name":"Division of Cardiology, Cremona Hospital , Largo Priori Emilio, 1, 26100 Cremona 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