Evidence map›Paper›PMID 31783891›Full record

ReviewCritical care (London, England)2019

Levosimendan in the light of the results of the recent randomized controlled trials: an expert opinion paper.

Bernard Cholley, Bruno Levy, Jean-Luc Fellahi, Dan Longrois, Julien Amour, Alexandre Ouattara, Alexandre Mebazaa

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Critical care (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 5 pooled it
9.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 5 syntheses or guidelines pooled it, 61 citations in OpenAlex.

  1. Pooled it
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  3. Effects of levosimendan on the outcome of veno-arterial extracorporeal membrane oxygenation: a systematic review and meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2024
    Pooled it
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  6. Article
  7. Bibliometric analysis of levosimendan.International journal of cardiology. Heart & vasculature · 2025
    Review
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  15. Preventive ImpellaJournal of clinical medicine · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 1 country.

Bernard CholleyDepartment of Anesthesiology and Critical Care MedicineP, Hôpital Européen Georges Pompidou, AP-HP, 20 rue Leblanc, 75015, Paris, France. bernard.cholley@aphp.fr.ORCID http://orcid.org/0000-0001-6388-6011
Bruno LevyCHRU Nancy, Réanimation Médicale Brabois, Vandoeuvre-les Nancy, France.
Jean-Luc FellahiDepartment of Anesthesiology and Critical Care, Hôpital Cardiologique Louis Pradel, Lyon, France.
Dan LongroisDepartment of Anesthesiology and Critical Care, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France.
Julien AmourDepartment of Anesthesiology and Critical Care Medicine, Hôpital de La Pitié Salpêtrière, AP-HP, Paris, France.
Alexandre OuattaraDepartment of Anesthesiology and Critical Care, Magellan Medico-Surgical Center, Bordeaux, France.
Alexandre MebazaaUniversité Paris Diderot, Sorbonne Paris Cité, Paris, France.
Université Claude Bernard Lyon 1 · FRCentre Hospitalier Régional et Universitaire de Nancy · FRDélégation Paris 5 · FRDélégation Paris 7 · FRSorbonne Université · FRUniversité de Bordeaux · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Despite interesting and unique pharmacological properties, levosimendan has not proven a clear superiority to placebo in the patient populations that have been enrolled in the various recent multicenter randomized controlled trials. However, the pharmacodynamic effects of levosimendan are still considered potentially very useful in a number of specific situations.Patients with decompensated heart failure requiring inotropic support and receiving beta-blockers represent the most widely accepted indication. Repeated infusions of levosimendan are increasingly used to facilitate weaning from dobutamine and avoid prolonged hospitalizations in patients with end-stage heart failure, awaiting heart transplantation or left ventricular assist device implantation. New trials are under way to confirm or refute the potential usefulness of levosimendan to facilitate weaning from veno-arterial ECMO, to treat cardiogenic shock due to left or right ventricular failure because the current evidence is mostly retrospective and requires confirmation with better-designed studies. Takotsubo syndrome may represent an ideal target for this non-adrenergic inotrope, but this statement also relies on expert opinion. There is no benefit from levosimendan in patients with septic shock. The two large trials evaluating the prophylactic administration of levosimendan (pharmacological preconditioning) in cardiac surgical patients with poor left ventricular ejection fraction could not show a significant reduction in their composite endpoints reflecting low cardiac output syndrome with respect to placebo. However, the subgroup of those who underwent isolated CABG appeared to have a reduction in mortality. A new study will be required to confirm this exploratory finding.Levosimendan remains a potentially useful inodilator agent in a number of specific situations due to its unique pharmacological properties. More studies are needed to provide a higher level of proof regarding these indications.

Indexed as

Cardiotonic AgentsHeart FailureHumansPerioperative MedicineRandomized Controlled Trials as TopicSimendanCardiotonic AgentsSimendanBeta-blockerCardiogenic shockCatecholamineHeart failureLevosimendan

Identifiers

PMID31783891
PMCPMC6883606
OpenAlexW2990269274

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.