6.2.2 Exclusion criterium: Female patients who are pregnant or nursing 6.2.7 Remuneration: Remuneration will be provided for each study related visit, according to effective costs, not exceeding € 25, - per visit. 6.4.1 Treatment Plan: After randomization patient will enter the treatment period, which will last for six weeks. Levosimendan will be infused on an outpatient basis for six hours at a dosage of 0,2 μg/kg/min without a bolus. Medical surveillance will be continued for additional three hours after completion of study drug administration before patients' discharge. Diuretics should be withheld at the day of study drug administration. If severe hypotension occurs during levosimendan infusion despite optimized fluid anagement dose of study medication will be cut in halve (= 0.1 mg/kg/min). In case of persisting hypotension study medication will be stopped temporarily and reinstalled if considered appropriate by the treating physician. Drug administration will be performed in intervals of two weeks (+/-3days). Following the treatment period patients enter the followup- period, which will last for additional 18 weeks. Follow-up visits will be scheduled at two weeks and 18 weeks, respectively, after finishing the treatment period. 6.5.1 Laboratory Tests: Prior to each administration of Levosimendan and each follow-up visit blood will be taken: 3 Venous serum samples and 2 plasma samples (45mls) will be collected and centrifuged for 10 min at 40°C. 3 aliquots of serum and 2 aliquots of plasma will be stored at – 70°C for testing the following parameters. - Markers of inflammatory activation (IL-6, IL-10 and TNF-alpha) and of the apoptotic process (Afas, SFAS Ligand) - Markers of oxidative stress (MDA, protein carbonyls, nitrotyrosine) - NT-pro-BNP 1 EDTA Blood sample will be drawn for testing Hb, Htk, Thrombocytes, Leucocytes, Na, K, Creatinin; A pregnancy test will be performed before inclusion of the female participant into the trial.

4.5 Blinding: Will be performed by a certified company or institution (Anstaltsapotheke or Abbott).

6.5.1 Laboratory Tests: Prior to each administration of Levosimendan and each follow-up visit blood will be taken: 3 Venous serum samples and 2 EDTA plasma samples (45mls) will be collected and centrifuged at 1600 g (RCF – relative centrifugal force) for 10 min at room temperature. 3 aliquots of serum and 2 aliquots of plasma will be stored at – 70°C for testing the following parameters. 6.5.4 Kansas City Cardiomyopathy Questionaire: Questionnaires will be stored in studycenter. 6.4.1. Treatment Plan: Diuretics should be withheld at the day of study drug administration. If severe hypotension occurs during levosimendan infusion despite optimized fluid management dose of study medication will be cut in halve (= 0.1 μg/kg/min). In case of persisting hypotension study medication will be stopped temporarily and reinstalled if considered appropriate by the treating physician. Drug administration will be performed in intervals of two weeks (+/-3days). In total study drug will be administered 4 times throughout the study period, requiring 4 vials of the allocated medication.

6.2.2. Exclusion Criterium: Implantation of a cardiac resynchronisation device during the last three months 5.2 Secondary efficacy objectives: Cardiac death will be divided into arrhythmic death and pump failure death. Adjudication of endpoints is assigned to the independent Data Safety and Monitoring Board.

4.1. Levosimendan: Levosimendan (Simdax) is manufactured by Orion Pharma, Espoo, Finland and will be supplied by PharMore. 6.1.2. Timing of the study: The study will start in September 2009. Randomization of the patients will be finished at the end of 2011. Final results should be available in the second quarter of 2012. 7.3. Reporting Procedures: According to the current local law in the event of an SAE and unexpected adverse events report must be made to the ethics committee, AGES and Orion Pharma Finland. The Pharmakovigilance Center, who is informed by the Investigator within 24 hours reports the SAE`s respectively SUSARs to Orion Pharma Finland.