The significant morbidity and mortality associated with heart failure with reduced (HFrEF) or preserved ejection fraction (HFpEF) justify the search for novel therapeutic agents. The nitric oxide (NO)–soluble guanylate cyclase (sGC)-cyclic guanosine monophosphate (cGMP) pathway plays an important role in the regulation of cardiovascular function. This pathway is disrupted in HF resulting in decreased protection against myocardial injury. The sGC activator cinaciguat increases cGMP levels by direct, NO-independent activation of sGC, and may be particularly effective in conditions of increased oxidative stress and endothelial dysfunction, and then reduced NO levels, but this comes at the expense of a greater risk of hypotension. Conversely, sGC stimulators (riociguat and vericiguat) enhance sGC sensitivity to endogenous NO, and then exert a more physiological action. The phase 3 VICTORIA trial found that vericiguat is safe and effective in patients with HFrEF and recent HF decompensation. Therefore, adding vericiguat may be considered in individual patients with HFrEF, particularly those at higher risk of HF hospitalization; the efficacy of the sacubitril/valsartan-vericiguat combination in HFrEF is currently unknown.

Aimo, A., Castiglione, V., Vergaro, G., Panichella, G., Senni, M., Lombardi, C., et al. (2021). The place of vericiguat in the landscape of treatment for heart failure with reduced ejection fraction. HEART FAILURE REVIEWS [10.1007/s10741-021-10146-1].

The place of vericiguat in the landscape of treatment for heart failure with reduced ejection fraction

Senni M;
2021

Abstract

The significant morbidity and mortality associated with heart failure with reduced (HFrEF) or preserved ejection fraction (HFpEF) justify the search for novel therapeutic agents. The nitric oxide (NO)–soluble guanylate cyclase (sGC)-cyclic guanosine monophosphate (cGMP) pathway plays an important role in the regulation of cardiovascular function. This pathway is disrupted in HF resulting in decreased protection against myocardial injury. The sGC activator cinaciguat increases cGMP levels by direct, NO-independent activation of sGC, and may be particularly effective in conditions of increased oxidative stress and endothelial dysfunction, and then reduced NO levels, but this comes at the expense of a greater risk of hypotension. Conversely, sGC stimulators (riociguat and vericiguat) enhance sGC sensitivity to endogenous NO, and then exert a more physiological action. The phase 3 VICTORIA trial found that vericiguat is safe and effective in patients with HFrEF and recent HF decompensation. Therefore, adding vericiguat may be considered in individual patients with HFrEF, particularly those at higher risk of HF hospitalization; the efficacy of the sacubitril/valsartan-vericiguat combination in HFrEF is currently unknown.
Articolo in rivista - Articolo scientifico
Cyclic guanosine monophosphate; Heart failure; Soluble guanylate cyclase; Treatment; Vericiguat;
English
Aimo, A., Castiglione, V., Vergaro, G., Panichella, G., Senni, M., Lombardi, C., et al. (2021). The place of vericiguat in the landscape of treatment for heart failure with reduced ejection fraction. HEART FAILURE REVIEWS [10.1007/s10741-021-10146-1].
Aimo, A; Castiglione, V; Vergaro, G; Panichella, G; Senni, M; Lombardi, C; Emdin, M
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/373431
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