What is the clinical evidence from this study?

Study design: Observational. Population: Heart failure with reduced ejection fraction (HFrEF) (n=504). Intervention: Vericiguat vs. Low-dose (≤5 mg). Primary outcome: Change in log-transformed NT-proBNP at 3 months (least-squares geometric mean ratio) (95% CI -0.247 to -0.004, p=0.043).

What question did this study set out to answer?

This research aims to understand how vericiguat treatment affects natriuretic peptide levels and cardiac structure in heart failure patients.

March 29, 2026Circulation Journal0 citationsOpen Access

Changes in Natriuretic Peptide Levels and Cardiac Structure in Patients Treated With Vericiguat

KKKenji KanenawaKokura Memorial Hospital KAKenji AndoKokura Memorial Hospital TNTakahito NasuIwate Medical University

Key Result

High-dose vericiguat (7.5 or 10 mg) was independently associated with a significantly greater reduction in NT-proBNP at 3 months compared to low-dose (≤5 mg), but not with cardiac reverse remodeling.

Key Points

This research aims to understand how vericiguat treatment affects natriuretic peptide levels and cardiac structure in heart failure patients.
Analyzed NT-proBNP levels from baseline to follow-up in patients with HFrEF.
Assessed cardiac remodeling through echocardiography and biomarkers.
Studied the effects of vericiguat on these parameters.
Observed changes in NT-proBNP levels following vericiguat treatment.
Indicated alterations in cardiac structure as assessed by imaging.
Examined potential correlations between peptide levels and cardiac remodeling.

Study Design

Type

Observational (n=504)

Multicenter

Yes

Structured PICO

Does vericiguat improve NT-proBNP levels and cardiac remodeling in patients with HFrEF?

Population

Adults (age ≥20 years) with heart failure with reduced ejection fraction (HFrEF, LVEF <45%), mean age 68.4, 73.6% male

Intervention

Vericiguat (high dose: 7.5 or 10 mg; low dose: <5 mg)

Outcome

Change in log-transformed NT-proBNP from baseline to follow-up (primarily at 3 months) and changes in cardiac remodeling at 12 months (LVEF, LVEDV, LVESV, E/A ratio, and E/e' ratio)surrogate

In a real-world registry of HFrEF patients, high-dose vericiguat was associated with sustained dose-dependent reductions in NT-proBNP but did not significantly induce cardiac reverse remodeling.

Main Result

Absolute Event Rate: 0.53% vs 0.65%

p-value: p=0.043

Limitations

Survival bias, as only patients who survived for at least 6 months and had available echocardiogram data were enrolled
Lack of a control group not treated with vericiguat
Potential underreporting or misclassification of events due to retrospective data collection from electronic medical records
Effects of subsequent treatments or medications initiated after baseline were not assessed
Limited generalizability to other countries as the study was conducted exclusively in Japan

Abstract

Background: Changes in N-terminal pro B-type natriuretic peptide (NT-proBNP) levels and cardiac remodeling from baseline to follow-up in patients with heart failure with reduced ejection fraction (HFrEF) treated with vericiguat remain unclear.

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Cite This Study

Kanenawa et al. (Thu,) conducted a observational in Heart failure with reduced ejection fraction (HFrEF) (n=504). Vericiguat vs. Low-dose (≤5 mg) was evaluated on Change in log-transformed NT-proBNP at 3 months (least-squares geometric mean ratio) (95% CI -0.247 to -0.004, p=0.043). High-dose vericiguat (7.5 or 10 mg) was independently associated with a significantly greater reduction in NT-proBNP at 3 months compared to low-dose (≤5 mg), but not with cardiac reverse remodeling.

synapsesocial.com/papers/69c8c15ade0f0f753b39bc24 https://doi.org/https://doi.org/10.1253/circj.cj-25-1087