Cardiology Letters 2021, 30(5):255-259

Stimulation of soluble guanylate cyclase - a novel treatment target in heart failure

Luknár M, Gonçalvesová E

Kardiologická klinika Lekárská fakulta Univerzita Komenského a Národného ústav srdcových a cievnych chorôb, a. s., Bratislava, Slovenská republika

Despite recent advances in the treatment, congestive heart failure (HF) with reduced left ventricular ejection fraction remains closely associated with risk of progression, need for frequent hospital admission, impaired quality of life, and high mortality. Intensive search for novel treatment options is therefore warranted. One of the perspective pathophysiologic pathways to become a treatment target is the nitric oxide (NO) - soluble guanylate cyclase (sGC) - cyclic guanosine monophosphate (cGMP) pathway. In HF, this pathway is dysregulated which results in low cGMP concentration and a negative cardiovascular impact. Vericiguat is an sGC stimulator that increases the activity of NO in both NO-dependent and direct, NO-independent ways. In a randomized controlled trial in patients with worsening HF with reduced left ventricular ejection fraction, vericiguat reduced the composite endpoint of cardiovascular mortality and hospitalisations for HF. Current Guidelines of the European Society of Cardiology recommend that vericiguat may be considered in patients in NYHA class II to IV who have had worsening HF despite treatment with a standard medication to reduce the risk of cardiovascular mortality or HF hospitalization.

Keywords: heart failure; nitric oxide; guanylate cyclase; vericiguat; treatment

Published: May 1, 2021  Show citation