Tricarico Lucia, Correale Michele, Bevere Ester Maria Lucia, Daniele Brunetti Natale, Iacoviello Massimo
Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy.
Cardiothoracic Department, Ospedali Riuniti University Hospital, 71122 Foggia, Italy.
Rev Cardiovasc Med. 2025 Aug 29;26(8):39886. doi: 10.31083/RCM39886. eCollection 2025 Aug.
Heart failure with reduced ejection fraction (HFrEF) is a progressive condition that is associated with high rates of morbidity, frequent hospitalizations, and significant mortality. Despite advancements in guideline-directed medical therapy (GDMT), many patients continue to be at risk for worsening heart failure (WHF). Vericiguat is a novel soluble guanylate cyclase (sGC) stimulator that targets the impaired nitric oxide (NO)-sGC-cyclic guanosine monophosphate (cGMP) pathway. Thus, by improving vascular and myocardial function, vericiguat offers a promising therapeutic option for patients with HFrEF who remain symptomatic despite receiving optimal medical treatment. This review explores the pathophysiological rationale, mechanism of action, and clinical evidence supporting the use of vericiguat. We analyze data from key randomized controlled trials (RCTs), such as SOCRATES-REDUCED and VICTORIA, as well as meta-analyses, to assess the efficacy and safety of using vericiguat in HFrEF. Additionally, we review real-world studies to evaluate the applicability of vericiguat in clinical practice.
射血分数降低的心力衰竭（HFrEF）是一种进行性疾病，与高发病率、频繁住院和高死亡率相关。尽管在指南指导的药物治疗（GDMT）方面取得了进展，但许多患者仍有心力衰竭恶化（WHF）的风险。维立西呱是一种新型可溶性鸟苷酸环化酶（sGC）刺激剂，作用于受损的一氧化氮（NO）-sGC-环磷酸鸟苷（cGMP）途径。因此，通过改善血管和心肌功能，维立西呱为尽管接受了最佳药物治疗仍有症状的HFrEF患者提供了一种有前景的治疗选择。本综述探讨了支持使用维立西呱的病理生理原理、作用机制和临床证据。我们分析了关键随机对照试验（RCT）的数据，如SOCRATES-REDUCED和VICTORIA，以及荟萃分析，以评估维立西呱在HFrEF中的疗效和安全性。此外，我们还回顾了真实世界研究，以评估维立西呱在临床实践中的适用性。
