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RecruitingNCT07288398LEVEL-2Updated Aug 19, 2026

LEVEL-2: LEVosimendan to Improve Exercise Limitation in Patients With PH-HFpEF-2

A Phase 3 interventional study of TNX-103 and Placebo in Pulmonary Hypertension Associated With HFpEF, sponsored by Tenax Therapeutics, Inc.. Recruiting at 141 sites in 15 countries. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2026-08-19.

Sponsored by Tenax Therapeutics, Inc. · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Started Mar 2026; still recruiting 7 months later.
Phase
Phase 3
Study type
Interventional
Enrollment
540
Allocation
Randomized
Ages
18 Years to 85 Years
Sex
All
01

Study summary

The purpose of this study is to assess the efficacy and safety of the study drug, levosimendan (given orally), compared to placebo in participants with pulmonary hypertension with heart failure with preserved left ventricular ejection fraction (PH-HFpEF) as measured by the change in 6-Minute Walk Distance.

Read the detailed description

Approximately 540 participants will be randomized in a 2:1 ratio to receive an oral dose of levosimendan or placebo. Participants will be eligible for an open label extension (OLE) of 52-weeks.

02

Conditions studied

  • Pulmonary Hypertension Associated With HFpEF

Browse trials for

Keywords

  • PH-HFpEF
  • levosimendan
  • HFpEF
  • Heart Failure
  • Pulmonary Hypertension Group 2
03

In context

Heart Failure

5,701 studies on the registry are indexed under Heart Failure; 1,220 are open to participants now.

This study's planned enrollment of 540 is above the median of 72 across 3,736 interventional studies indexed under Heart Failure.

Browse Heart Failure studies →

Lead sponsor

Tenax Therapeutics, Inc. is the lead sponsor of 9 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Men or women, ≥18 to 85 years of age
  2. NYHA Class II or III or ambulatory NYHA Class IV symptoms
  3. A diagnosis of World Health Organization (WHO) Group 2 PH-HFpEF with qualifying hemodynamics verified by right heart catheterization (RHC)
  4. A qualifying baseline RHC
  5. A qualifying echocardiogram
  6. A qualifying 6-MWD
  7. A 48-hour ambulatory cardiac rhythm monitor during the Screening Period
  8. Requirements related to child bearing potential, contraception, and egg/sperm donation)

Exclusion criteria

Exclusion Criteria:

  1. A diagnosis of PH WHO Groups 1, 3, 4, or 5
  2. Echocardiographic evidence for hypertrophic cardiomyopathy, restrictive cardiomyopathy, constrictive pericarditis, cardiac amyloidosis, or infiltrative cardiomyopathy
  3. Structural heart repair or replacement of the aortic valve or mitral valve (surgical or percutaneous) OR, planned valve intervention OR, the presence of significant valve disease
  4. A diagnosis of pre-existing lung disease
  5. History of severe allergic or anaphylactic reaction or hypersensitivity to the excipients in the investigational product
  6. Major surgery within 60 days
  7. Prior heart, lung, or heart-lung transplants or life expectancy of \<12 months
  8. History of clinically significant other diseases that may limit or complicate participation in the study
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
540 participants (estimated)

Study arms

  • Placebo comparator
    Placebo

    Matching placebo (oral)

    Drug: Placebo

  • Active comparator
    TNX-103

    Oral levosimendan

    Drug: TNX-103

Interventions

  • DrugTNX-103

    Oral levosimendan

  • DrugPlacebo

    Matching placebo (oral)

06

What researchers measure

Primary outcomes

  1. 6-Minute Walk Distance (6MWD)

    Change in 6-minute walk distance

    Time frame: 26 weeks

Secondary outcomes

  1. KCCQ (Kansas City Cardiomyopathy Questionnaire) score is a standardized measure that ranges from 0 to 100, where a higher score indicates better health.

    Change in KCCQ Total Symptom Score

    Time frame: 26 weeks

  2. Clinical Worsening Events

    Number of Clinical Worsening Events

    Time frame: 26 weeks

  3. Clinical Worsening Event

    Time to first occurrence of a Clinical Worsening Event

    Time frame: 26 weeks

  4. NYHA (New York Heart Association) classification assesses and categorizes a patient's physical ability and symptoms into four classes, the lower the classification, the least impact on physical activity.

    Change in NYHA Functional Class

    Time frame: 26 weeks

07

Study locations

48 of 141 sites recruiting
  • Tenax Investigational Site
    Alexander City, Alabama 35010, United States
    Recruiting
  • Tenax Investigational Site
    Tucson, Arizona 85724, United States
    Not yet recruiting
  • Tenax Investigational Site
    Sacramento, California 95816, United States
    Not yet recruiting
  • Tenax Investigational Site
    San Francisco, California 94143, United States
    Not yet recruiting
  • Tenax Investigational Site
    Stanford, California 94305-5208, United States
    Not yet recruiting
  • Tenax Investigational Site
    Torrance, California 90502, United States
    Not yet recruiting
  • Tenax Investigational Site
    Athens, Georgia 30606, United States
    Not yet recruiting
  • Tenax Investigational Site
    Atlanta, Georgia 30322, United States
    Not yet recruiting
  • Tenax Investigational Site
    Chicago, Illinois 60611-4494, United States
    Not yet recruiting
  • Tenax Investigational Site
    Chicago, Illinois 60637, United States
    Not yet recruiting
  • Tenax Investigational Site
    Mount Prospect, Illinois 60056, United States
    Not yet recruiting
  • Tenax Investigational Site
    Peoria, Illinois 61636, United States
    Recruiting
  • Tenax Investigational Site
    Indianapolis, Indiana 46260, United States
    Recruiting
  • Tenax Investigational Site
    New Orleans, Louisiana 70115-6969, United States
    Recruiting
  • Tenax Investigational Site
    West Monroe, Louisiana 71291, United States
    Recruiting
  • Tenax Investigational Site
    Boston, Massachusetts 02114-2621, United States
    Not yet recruiting
  • Tenax Investigational Site
    Ann Arbor, Michigan 48109, United States
    Not yet recruiting
  • Tenax Investigational Site
    Ypsilanti, Michigan 48197, United States
    Recruiting
  • Tenax Investigational Site
    Minneapolis, Minnesota 55455, United States
    Not yet recruiting
  • Tenax Investigational Site
    Rochester, Minnesota 55905, United States
    Not yet recruiting
  • Tenax Investigational Site
    Kansas City, Missouri 64111, United States
    Not yet recruiting
  • Tenax Investigational Site
    St Louis, Missouri 63136, United States
    Not yet recruiting
  • Tenax Investigational Site
    Omaha, Nebraska 68198, United States
    Recruiting
  • Tenax Investigational Site
    Reno, Nevada 89502, United States
    Recruiting
  • Tenax Investigational Site
    New York, New York 10021, United States
    Recruiting
  • Tenax Investigational Site
    New York, New York 10032, United States
    Recruiting
  • Tenax Investigational Site
    Rochester, New York 14617, United States
    Recruiting
  • Tenax Investigational Site
    Durham, North Carolina 27710, United States
    Recruiting
  • Tenax Investigational Site
    Winston-Salem, North Carolina 27101, United States
    Recruiting
  • Tenax Investigational Site
    Cleveland, Ohio 44195-0001, United States
    Not yet recruiting
  • Tenax Investigational Site
    Columbus, Ohio 43210, United States
    Not yet recruiting
  • Tenax Investigational Site
    Allentown, Pennsylvania 18105, United States
    Not yet recruiting
  • Tenax Investigational Site
    Pittsburgh, Pennsylvania 15212, United States
    Not yet recruiting
  • Tenax Investigational Site
    Wynnewood, Pennsylvania 19096-3450, United States
    Not yet recruiting
  • Tenax Investigational Site
    Charleston, South Carolina 29425, United States
    Not yet recruiting
  • Tenax Investigational Site
    Nashville, Tennessee 37205, United States
    Recruiting
  • Tenax Investigational Site
    Austin, Texas 78705, United States
    Recruiting
  • Tenax Investigational Site
    Dallas, Texas 75390, United States
    Recruiting
  • Tenax Investigational Site
    El Paso, Texas 79905-2707, United States
    Not yet recruiting
  • Tenax Investigational Site
    Houston, Texas 77002, United States
    Withdrawn
  • Tenax Investigational Site
    Houston, Texas 77030-2342, United States
    Not yet recruiting
  • Tenax Investigational Site
    Charlottesville, Virginia 22908, United States
    Not yet recruiting
  • Tenax Investigational Site
    Norfolk, Virginia 23507-1904, United States
    Not yet recruiting
  • Tenax Investigational Site
    Seattle, Washington 98122, United States
    Not yet recruiting
  • Tenax Investigational Site
    Madison, Wisconsin 53706, United States
    Not yet recruiting
  • Tenax Investigational Site
    Marshfield, Wisconsin 54449, United States
    Recruiting
  • Tenax Investigational Site
    San Juan Bautista, Buenos Aires 1888, Argentina
    Not yet recruiting
  • Tenax Investigational Site
    Buenos Aires, Buenos Aires F.D. 1280, Argentina
    Not yet recruiting
  • Tenax Investigational Site
    Buenos Aires, C1180AAX, Argentina
    Not yet recruiting
  • Tenax Investigational Site
    Buenos Aires, C1428ART, Argentina
    Not yet recruiting
  • Tenax Investigational Site
    Corrientes, W3400AMZ, Argentina
    Not yet recruiting
  • Tenax Investigational Site
    Córdoba, 5000, Argentina
    Not yet recruiting
  • Tenax Investigational Site
    Córdoba, X5016KET, Argentina
    Not yet recruiting
  • Tenax Investigational Site
    San Luis, D5702JRS, Argentina
    Not yet recruiting
  • Tenax Investigational Site
    Santa Fe, S2002KDS, Argentina
    Not yet recruiting
  • Tenax Investigational Site
    Vienna, State of Vienna 1090, Austria
    Not yet recruiting
  • Tenax Investigational Site
    Braunau am Inn, 5280, Austria
    Recruiting
  • Tenax Investigational Site
    Graz, 8036, Austria
    Recruiting
  • Tenax Investigational Site
    Klagenfurt, 9020, Austria
    Not yet recruiting
  • Tenax Investigational Site
    Sankt Pölten, 3100, Austria
    Recruiting
  • Tenax Investigational Site
    Vienna, 1100, Austria
    Not yet recruiting
  • Tenax Investigational Site
    Salvador, Estado de Bahia 40170-130, Brazil
    Not yet recruiting
  • Tenax Investigational Site
    Goiânia, Goiás 74605, Brazil
    Not yet recruiting
  • Tenax Investigational Site
    Belo Horizonte, Minas Gerais 30220, Brazil
    Not yet recruiting
  • Tenax Investigational Site
    Curitiba, Paraná 80215-901, Brazil
    Not yet recruiting
  • Tenax Investigational Site
    Porto Alegre, Rio Grande do Sul 90020-090, Brazil
    Not yet recruiting
  • Tenax Investigational Site
    Porto Alegre, Rio Grande do Sul 90035-903, Brazil
    Not yet recruiting
  • Tenax Investigational Site
    Ribeirão Preto, São Paulo 14026-020, Brazil
    Not yet recruiting
  • Tenax Investigational Site
    Burgas, 8000, Bulgaria
    Recruiting
  • Tenax Investigational Site
    Pleven, 5800, Bulgaria
    Not yet recruiting
  • Tenax Investigational Site
    Sofia, 1309, Bulgaria
    Not yet recruiting
  • Tenax Investigational Site
    Sofia, 1407, Bulgaria
    Recruiting
  • Tenax Investigational Site
    Sofia, 1431, Bulgaria
    Recruiting
  • Tenax Investigational Site
    Sofia, 1750, Bulgaria
    Not yet recruiting
  • Tenax Investigational Site
    Ostrava, 72880, Czechia
    Not yet recruiting
  • Tenax Investigational Site
    Prague, 10034, Czechia
    Not yet recruiting
  • Tenax Investigational Site
    Prague, 15006, Czechia
    Not yet recruiting
  • Tenax Investigational Site
    Le Kremlin-Bicêtre, 94270, France
    Recruiting
  • Tenax Investigational Site
    Montpellier, 34295, France
    Not yet recruiting
  • Tenax Investigational Site
    Nantes, 44007, France
    Recruiting
  • Tenax Investigational Site
    Nice, 06001, France
    Not yet recruiting
  • Tenax Investigational Site
    Pau, 64000, France
    Not yet recruiting
  • Tenax Investigational Site
    Poitiers, 86000, France
    Not yet recruiting
  • Tenax Investigational Site
    Bad Bevensen, 29549, Germany
    Not yet recruiting
  • Tenax Investigational Site
    Bad Nauheim, 61231, Germany
    Not yet recruiting
  • Tenax Investigational Site
    Berlin, 12683, Germany
    Not yet recruiting
  • Tenax Investigational Site
    Dresden, 01307, Germany
    Not yet recruiting
  • Tenax Investigational Site
    Hamburg, 20251, Germany
    Not yet recruiting
  • Tenax Investigational Site
    Jena, 07747, Germany
    Not yet recruiting
  • Tenax Investigational Site
    Mainz, 55131, Germany
    Not yet recruiting
  • Tenax Investigational Site
    Budapest, 1122, Hungary
    Recruiting
  • Tenax Investigational Site
    Budapest, 1134, Hungary
    Not yet recruiting
  • Tenax Investigational Site
    Debrecen, 4032, Hungary
    Recruiting
  • Tenax Investigational Site
    Szeged, 6275, Hungary
    Not yet recruiting
  • Tenax Investigational Site
    Acquaviva delle Fonti, 70021, Italy
    Not yet recruiting
  • Tenax Investigational Site
    Bergamo, 24127, Italy
    Not yet recruiting
  • Tenax Investigational Site
    Messina, 98125, Italy
    Not yet recruiting
  • Tenax Investigational Site
    Milan, 20132, Italy
    Not yet recruiting
  • Tenax Investigational Site
    Milan, 20138, Italy
    Not yet recruiting
  • Tenax Investigational Site
    Milan, 20149, Italy
    Not yet recruiting

Showing the first 100 of 141 sites across 15 countries.

08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 19, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07288398
Lead sponsor
Tenax Therapeutics, Inc.
Responsible party
Sponsor
First posted
Dec 17, 2025
Start date
Mar 3, 2026
Primary completion
Jun 30, 2028 (estimated)
Completion
Jun 30, 2029 (estimated)
Last update
Aug 19, 2026

Study contacts

Akshata Ashokkumar
Contact
a.ashokkumar@tenaxthera.com
(919) 855-2118
Katelyn Jansson
Contact
k.jansson@tenaxthera.com
(919) 855-2119

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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