Vericiguat Experience in Durable Left Ventricular Assist Device Patients

Durable left ventricular assist devices (LVADs) improve outcomes for advanced heart failure (HF) patients. Vericiguat, which enhances HF outcomes by affecting systemic and pulmonary vasculature, may benefit LVAD patients as well.

The study aimed to investigate the safety and efficacy of Vericiguat in patient on LVAD support. This retrospective analysis included patients supported with LVAD who were treated with Vericiguat. Safety outcomes comprised LVAD-related hemocompatibility-related adverse events (HRAE) and Vericiguat adverse events. Efficacy outcomes included changes in NYHA functional class and NT-proBNP levels.

We identified eight HeartMate3 patients treated with Vericiguat. Median age was 65 years-old, 87.5% were men, and median duration on Vericiguat therapy was 254 days (161-272). None of the patients had experienced HRAE, adverse events related to Vericiguat or died. A reduction in pulmonary capillary wedge pressure was observed (17 [16-23.5] vs. 9 [6.5-11] mmHg, p = 0.06), along with an increase in cardiac index (from 1.9 [1.5-2.6] to 2.1 [1.8-3.2] L/min/m², p = 0.12) and right ventricle stroke work index (5.4 [4.1, 7.0] vs. 7.5 [6.9, 9.2] g/m/beat/m², p = 0.043). NT-proBNP levels (2171 [779-3366] vs. 1677 [406-2490] pg/mL, p = 0.438) decreased but did not reach statistical significance.

Preliminary results suggests that Vericiguat therapy in LVADs is safe and indicates a trend toward improved efficacy.