Advance in the application of vericiguat in heart failure

Abstract:

The development and progression of heart failure involves vascular endothelial dysfunction，inflammation，and oxidative stress，and this pathophysiological process affects the activity of the nitric oxide（NO）-soluble guanylate cyclase（sGC）-cyclic guanosine monophosphate（cGMP） signaling pathway. Vericiguat can increase the level of cGMP by stimulating sGC，and as a second messenger to activate protein kinases，phosphodiesterases，and subsequent signaling pathways，cGMP can dilate blood vessels，improve coronary blood flow，and inhibit the progression of inflammation and myocardial fibrosis，thereby improving the prognosis of patients with heart failure. At present，several clinical studies have been conducted for vericiguat in the treatment of heart failure with reduced ejection fraction and heart failure with preserved ejection fraction，and its safety in the treatment of heart failure patients has been widely confirmed，but its efficacy varies in different types of heart failure patients. This article reviews the changes in the NO-sGC-cGMP pathway during the onset of heart failure，the mechanism of action of vericiguat，and the advances in vericiguat in the treatment of heart failure.