What is the clinical evidence from this study?

Study design: Observational. Population: Chronic heart failure and reduced ejection fraction (HFrEF) (n=158). Intervention: Vericiguat vs. Standard heart failure treatment. Primary outcome: Peak Oxygen Consumption at 6 months (mL/kg/min) (p=0.001).

What does this research mean for the field?

Vericiguat added to standard therapy significantly improves exercise tolerance, including peak oxygen consumption and anaerobic threshold, at 6 months in patients with chronic heart failure and reduced ejection fraction. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

February 5, 2025BMC Cardiovascular Disorders16 citationsOpen Access

Efficacy of vericiguat in patients with chronic heart failure and reduced ejection fraction: a prospective observational study

YZYinge ZhanHebei Medical University QLQi LiChangchun University of Science and Technology JZJie ZhouHarbin Medical University

Key Result

Vericiguat added to standard therapy significantly improved peak oxygen consumption to 19.03 mL/kg/min compared to 16.01 mL/kg/min with standard therapy alone at 6 months in patients with HFrEF.

Study Design

Type

Observational (n=158)

Blinding

Open-label

Randomization

Pseudo-randomized (parity of hospital admission numbers)

Multicenter

Structured PICO

Does vericiguat added to standard therapy improve exercise tolerance (CPET parameters) and reduce heart failure readmissions in patients with HFrEF?

Population

158 patients aged 25 to 70 years with a definitive diagnosis of HFrEF (LVEF < 40%), mean age ~56, ~50% male, based in China. Key exclusions: acute myocardial infarction or stroke within 3 months, symptomatic hypotension or SBP < 100 mmHg, severe hepatic or renal dysfunction (Scr > 265 µmol/L).

Intervention

Vericiguat tablets, starting at 2.5 mg once daily with meals, doubled every 2 weeks to a maximum maintenance dose of 10 mg once daily, added to conventional heart failure treatment for 6 months.

Comparator

Standard heart failure treatment (including diuretics, beta-blockers, ACEI/ARB/ARNI, mineralocorticoid receptor antagonists, SGLT2 inhibitors, etc.) without vericiguat.

Outcome

Changes in cardiopulmonary exercise testing (CPET) parameters (Peak Oxygen Consumption, Anaerobic Threshold, Carbon Dioxide Equivalent Slope) and Weber Functional Classification at 6 months post-discharge.surrogate

Main Result

Absolute Event Rate: 19.03% vs 16.01%

p-value: p=0.001

Limitations

Single-center design
Small sample size
Short follow-up period
Insufficient assessment of practical limitations of CPET evaluation (time consumption, economic burden, and safety risks)

Abstract

OBJECTIVES: This study aims to evaluate the therapeutic effect of Vericiguat through cardiopulmonary exercise testing (CPET) in patients with chronic heart failure and reduced ejection fraction (HFrEF). METHODS: A prospective observational study was conducted from May 2022 to May 2023, focusing on patients with HFrEF admitted to our hospital. Eligible patients were sequentially numbered and enrolled based on specific inclusion and exclusion criteria. They were divided into two groups: one receiving standard heart failure therapy and the other receiving standard therapy plus Vericiguat. Data were collected at baseline and at 1, 3, and 6 months post-discharge, including NT-proBNP, sST2, and echocardiographic assessments. All patients underwent CPET before discharge and again six months post-discharge for within-subject comparisons. RESULTS: The study enrolled 158 patients, with 79 in each treatment arm. No significant baseline differences were observed in the Weber Functional Classification or CPET parameters. At six months, the Vericiguat group exhibited a significant reduction in patients classified as C (from 31.6 to 7.5%) and D (from 31.6 to 3.7%), with P values less than 0.05. Additionally, Vericiguat significantly improved Peak Oxygen Consumption (from 14.24 ± 6.21 to 19.03 ± 4.87 ml/kg/min) and Anaerobic Threshold (from 10.48 ± 3.82 to 13.48 ± 3.31 ml/kg/min). Compared to the standard treatment group, the Vericiguat group demonstrated significantly higher Peak Oxygen Consumption, Anaerobic Threshold, and a lower Carbon Dioxide Equivalent Slope, with P values all below 0.05. CONCLUSIONS: Vericiguat safely enhances exercise tolerance, as evaluated by CPET, in high-risk patients with HFrEF.

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