Efficacy and safety of levosimendan in acute heart failure patients with different body mass index: a multicenter, retrospective, observational real-world study

Objective: To evaluate the efficacy and safety of levosimendan in acute heart failure (AHF) patients with different body mass index (BMI) using real-world data. Methods: = 485). To assess the efficacy and safety of levosimendan in real-world AHF patients overall and across BMI groups, comparisons were made before and 7 days after treatment regarding heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), left ventricular ejection fraction (LVEF), NT-proBNP levels, cardiac function classification, respiratory symptoms, pulmonary rales, and adverse reactions. Results: > 0.05). Conclusions: 1. In patients with acute heart failure, levosimendan administration was associated with a decreasing trend in plasma NT-proBNP levels, an improvement in left ventricular ejection fraction, and alleviation of cardiac functional impairment and respiratory symptoms. Favorable safety profiles were generally observed during the treatment period. 2. Body mass index showed a negative correlation with NT-proBNP levels, suggesting that patients with higher BMI tend to have relatively lower baseline NT-proBNP levels. 3. In acute heart failure patients stratified by body mass index, levosimendan treatment exhibited between-group variations in clinical parameter improvements and safety profiles. Overweight and obese subgroups demonstrated a tendency toward more pronounced clinical improvement and fewer reported adverse events.