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Initiation of vericiguat and short-term cardiovascular function improvement in heart failure patients with and
Xinyu Zhang1,2,3, Wei Zhou4, Hui Liu5
1Cardiovascular Department, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Insights
Vericiguat improved heart function in patients with heart failure (HF) and varying degrees of renal dysfunction. This soluble guanylate cyclase stimulator showed benefits across all renal function groups, warranting further study.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Heart failure (HF) is a global health concern exacerbated by cardiorenal interactions.
- Vericiguat, a soluble guanylate cyclase (sGC) stimulator, is approved for heart failure with reduced ejection fraction (HFrEF).
- The study investigates vericiguat's impact on cardiac function in HF patients with renal dysfunction.
Purpose of the Study:
- To assess short-term cardiac function improvements from in-hospital vericiguat initiation.
- To evaluate vericiguat's efficacy in HF patients stratified by renal function.
- To analyze cardiovascular adverse events and left ventricular ejection fraction (LVEF) changes.
Main Methods:
- Retrospective cohort study of 401 HF patients initiated on vericiguat.
- Propensity score matching (PSM) refined the cohort to 217 patients across three renal function groups.
- Primary endpoint: 3 major adverse cardiovascular events (3P-MACE) within one year. Secondary endpoint: LVEF change at six months.
Main Results:
- Vericiguat therapy significantly improved LVEF by 11.8% overall (p < 0.001) after six months.
- The severe renal dysfunction group showed the largest LVEF increase (20.2%, p = 0.044).
- Lower survival probability and a trend toward higher cardiovascular event risk were observed in the severe renal dysfunction group.
Conclusions:
- Vericiguat enhances cardiac function in HF patients regardless of renal status.
- The findings support further investigation into vericiguat for HF patients with renal comorbidities.
- Optimization of treatment strategies for cardiorenal comorbidities is crucial.
Background:
Recognized as a global health issue, Heart failure (HF) is a complex clinical syndrome and often worsening due to cardiorenal interactions. vericiguat, a novel soluble guanylate cyclase (sGC) stimulator, is approved for treating heart failure (HF) with reduced ejection fraction (HFrEF). This study aims to assess the short-term improvement in cardio-function resulting from in-hospital initiation of vericiguat among patients with renal dysfunction.
Methods:
We conducted a single-center, retrospective cohort study encompassing 401 consecutive HF patients admitted from January 2023 to June 2024, who initiated vericiguat treatment post-admission. Following propensity score matching (PSM), the study cohort was refined to 217 patients, categorized into three groups based on renal function: 31 with severe renal dysfunction, 62 with moderate renal dysfunction, and 124 with normal renal function. All patients received oral vericiguat, with the primary endpoint being the incidence of three major cardiovascular adverse events (3P-MACE) within one year. The secondary endpoint evaluated the change in left ventricular ejection fraction (LVEF) after six months relative to baseline.
Results:
After six months of vericiguat therapy, a significant overall improvement in LVEF was observed (mean increase of 11.8%, p < 0.001). The severe renal dysfunction group demonstrated the most pronounced increase in LVEF (20.2%, p = 0.044), whereas the normal renal function group exhibited the most significant statistical improvement (10.9%, p < 0.001). Kaplan-Meier survival analysis revealed a markedly lower survival probability for the severe renal dysfunction group compared to the other groups (p < 0.001). The Cox proportional hazard regression model indicated a trend toward a higher risk of cardiovascular adverse events in the severe renal dysfunction group, which approached statistical significance after adjustments (HR = 137.64, p-value = 0.050).
Conclusion:
Vericiguat enhances cardiac function in HF patients, irrespective of renal function status, and merits further investigation for the optimization of treatment strategies in HF patients with renal comorbidities.
Clinical Trial Registration:
clinicaltrials.gov, identifier (Unique Protocol ID: 82100477-3).
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