Initial experience of vericiguat add-on therapy upon fantastic four medical therapy in a patient with systolic heart failure

• Published in: Journal of cardiology cases Vol. 26; no. 6; pp. 429 - 431
• Main Authors: Imamura, Teruhiko, Kinugawa, Koichiro
• Format: Journal Article
• Language: English
• Published: Japan Elsevier Ltd 01.12.2022; Japanese College of Cardiology
• Subjects: Case Report; Heart failure; Hemodynamics; Nitric oxide; Reverse remodeling; Heart failure; Hemodynamics; Reverse remodeling; Nitric oxide
• ISSN: 1878-5409; 1878-5409
• DOI: 10.1016/j.jccase.2022.08.012

The VICTORIA trial demonstrated that vericiguat, a novel oral soluble guanylate cyclase stimulator, improved mortality and morbidity in patients with systolic heart failure, receiving conventional anti-heart failure medications. However, the clinical implication of vericiguat for those receiving guideline-directed medical therapy including sodium-glucose cotransporter 2 inhibitors: fantastic four, remains unknown. We had a patient with systolic heart failure, whose heart failure symptoms improved as well as cardiac reverse remodeling following 3-month vericugat therapy upon fantastic four medical therapy. Vericiguat might have an additional effect on patients receiving fantastic four medical therapy, although further studies are warranted to validate and establish our hypothesis. Clinical implication of vericiguat, a novel oral soluble guanylate cyclase stimulator, in patients with systolic heart failure receiving “fantastic four” including sodium-glucose cotransporter 2 inhibitors remains uncertain. Vericiguat might have an additional effect on patients receiving fantastic four medical therapy.