The prolonged lowering effect of levosimendan on brain natriuretic peptide levels in patients with decompansated heart failure: clinical implications.

The release of brain natriuretic peptide (BNP) is increased in heart failure (HF). The plasma concentrations of BNP and N terminal pro-BNP (NT-proBNP) fall after effective pharmacologic treatment of HF, which suggests that measurements of plasma BNP may be helpful in evaluating therapy. Despite the initial reports that suggested a positive effect of levosimendan on short- and long-term survival in patients with severe HF, the results of the recently presented large-scale clinical trials provided rather controversial results. Further clinical studies are needed to end the confusion regarding the effects of levosimendan on prognosis in patients with decompansated HF.