Survival of Patients With Acute Heart Failure in Need of Intravenous Inotropic Support: a Multicentre, Parallel-Group, Randomised, Double-Blind, Double-Dummy Study of Levosimendan Versus Dobutamine in Patients With Acute Heart Failure.

Inclusion Criteria: Written, signed and dated informed consent Male and female patients over 18 years of age. Females of childbearing potential must have a negative pregnancy test and must refrain from breastfeeding. Women who are postmenopausal [two years since last menstrual cycle], surgically sterilised or who have undergone a hysterectomy are considered not to be of childbearing potential Hospitalised patients with acutely decompensated heart failure Left ventricular ejection fraction less than or equal to 30 % as assessed using echocardiography, radionuclide ventriculography or contrast angiography within 12 months Clinical need for intravenous inotropic support as evidenced by insufficient response to intravenous diuretics and/or vasodilators (nitroglycerin, nitroprusside) and at least one of the following at screening: oliguria (mean urine output < 30 ml/h for at least 6 hours) and not a result of hypovolemia dyspnoea at rest or mechanical ventilation for heart failure haemodynamic impairment in those patients with Swan-Ganz catheter inserted (PCWP ≥ 18 mmHg and/or Cardiac Index ≤ 2.2 l/min/m2) Exclusion Criteria: Severe obstruction of ventricular outflow tracts such as haemodynamically significant uncorrected primary valve disease or hypertrophic cardiomyopathy or impaired ventricular filling such as restrictive cardiomyopathy Weight ≥ 160 kg Cardiac surgery within 30 days before screening Stroke within 3 months before screening Systolic blood pressure persistently less than 85 mmHg at screening or at baseline Heart rate persistently 130 bpm or greater at screening or at baseline Serum potassium less than 3.5 mmol/l at screening Administration of any inotropic agent (e.g. dobutamine, milrinone, amrinone, enoximone, epinephrine, norepinephrine) except digitalis or dopamine (with dose of less than or equal than 2 mg/kg/min) during the current hospitalisation Hypersensitivity to levosimendan or dobutamine or any of their excipients A history of Torsades de Pointes Severe renal insufficiency (serum creatinine > 450 mmol/l [5.0 mg/dl]) or on dialysis Significant hepatic impairment at discretion of the investigator Acute bleeding Severe anemia (haemoglobin < 8 g/dl) at screening Septicaemia or septic shock Other serious diseases limiting life expectancy considerably (e.g. end-stage cancer) Participation in a clinical trial with any experimental treatment within 30 days prior to screening or previous participation in the present study Administration of levosimendan within 30 days prior to screening