韦里西瓜特,一种可溶性关酸环酶刺激剂,已被批准用于心力衰竭治疗
Mohammed Kallash1, William H Frishman1,2
1From the Department of Medicine, New York Medical College, School of Medicine, Valhalla, NY.
Cardiology in review
|June 20, 2025
概括
作为一种可溶性 guanylate cyclase 刺激剂的 vericiguat 在心力衰竭患者中显著减少了心血管死亡或心力衰竭住院的数量. 目前的指导方针建议在高风险的HFrEF患者中考虑接受治疗,这些患者最近症状恶化.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 生物化学 生物化学
背景情况:
- 心力衰竭 (HF) 是一个全球性流行病,患病率和死亡率很高.
- 降低的氧化 (NO) -可溶性瓜尼酸环酶 (sGC) -循环瓜诺辛单酸盐 (cGMP) 信号传递有助于降低射出分数 (HFrEF) 的HF的病理生理学.
- 异常包括NO生物可用性降低,sGC活性受损,固酶活性增加,导致cGMP水平降低.
研究的目的:
- 为了评估SGC刺激剂的 vericiguat在HFrEF患者的疗效和安全性.
- 研究NO-sGC-cGMP途径在HFrEF治疗中的作用.
- 评估输送器对高风险HFrEF患者心血管结局的影响.
主要方法:
- 进行了一项主要的临床试验,涉及HFrEF患者接受指导方针导向的医疗治疗.
- 参与者最近经历了HF的恶化.
- 韦里西瓜特是口服的,结果与安慰剂组进行了比较.
主要成果:
- 与安慰剂相比,维里西瓜特显著降低了心血管死亡或首次HF住院的复合情况.
- 该研究表明了向NO-sGC-cGMP途径的治疗潜力.
- 目前的指导方针建议在选择的高风险HFrEF患者中考虑接受治疗.
结论:
- 维里西瓜特代表了HFrEF药物治疗的重大进步.
- 在个性化治疗和确定最佳患者表型方面,仍然存在挑战.
- 需要进一步的研究来探索 vericiguat在慢性稳定的HFrEF中没有最近恶化的作用.
相关概念视频
01:26Heart Failure Drugs: Inotropic Agents
745
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
745
01:30Heart Failure V: Medical Management
34
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
34
01:18Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
228
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
228
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
524
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
524
01:22Heart Failure Drugs: Diuretics
505
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
505
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
260
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
260