20.500.12556/DiRROS-27692 Vericiguat Therapy Is Associated with Reverse Myocardial Remodeling in Chronic Heart Failure with Reduced Ejection Fraction Background and aims: Vericiguat lowers cardiovascular death or heart-failure hospitalization in recently worsened heart failure with reduced ejection fraction (HFrEF), but its effects on cardiac remodeling are less well characterized. Our aim was to evaluate whether the addition of vericiguat to guideline-directed medical therapy (GDMT) promotes reverse myocardial remodeling in patients with HFrEF and recent worsening. Methods: We conducted a prospective, non-randomized, single-center study enrolling 34 consecutive patients with HFrEF who had experienced recent worsening and were on stable GDMT for at least 3 months prior to decompensation. Clinical, biochemical, and echocardiographic assessments were performed at baseline and at 6 months. Results: A total of 24 patients completed the 6-month follow-up (mean age 63 ± 9 years; 92% male), 96% of whom were in New York Heart Association (NYHA) class III or IV. After 6 months of vericiguat therapy, right ventricular systolic function improved significantly, with an increase in tricuspid annular plane systolic excursion (TAPSE) from 18.5 ± 4.3 mm to 21.4 ± 4.8 mm (p = 0.003). Left ventricular systolic function improved, with a numerical increase in left ventricular ejection fraction (LVEF) (30.1 ± 5.9% to 32.2 ± 10.5%; p = 0.122) and a significant increase in left ventricular outflow tract velocity-time integral (LVOT VTI) (14.8 ± 3.7 cm to 16.1 ± 3.8 cm; p = 0.011). Functional improvements were accompanied by structural remodeling, including reductions in right ventricular internal diameter in diastole (RVIDd) (40.5 ± 5.8 mm to 37.9 ± 6.9 mm; p = 0.002) and left ventricular end-systolic volume (LVESV) (144.0 ± 40.3 mL to 132.4 ± 61.0 mL; p = 0.031). N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels also decreased significantly (median 1829.0 ng/mL to 1241.0 ng/mL; p = 0.03). Conclusions: In patients with HFrEF and recent worsening, the addition of vericiguat to GDMT may be associated with reverse myocardial remodeling. heart failure myocardial reverse remodeling soluble guanylate cyclase stimulator srčno popuščanje reverzno preoblikovanje miokarda topni stimulator gvanilat ciklaze true false true Angleški jezik Slovenski jezik Neznano 2026-02-19 14:06:03 2026-02-19 14:06:03 2026-02-20 03:51:46 0000-00-00 00:00:00 2026 0 0 Nasl. z nasl. zaslona; Opis vira z dne 11. 2. 2026; str. 1-15 iss. 1, [article no.] 17 Vol. 13 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.1 2308-3425 10.3390/jcdd13010017 268104195 RAZ_Bajec_Tine_2026.pdf RAZ_Bajec_Tine_2026.pdf 1 14DAD04C8F967631F79B9859BF5C5D4A 573bea149f96ef84dac0b9bd8fd9466f13ac92c2c49ddc0254cc86e22907984f 1bc1c848-0d94-11f1-9c9d-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=40645 https://www.mdpi.com/2308-3425/13/1/17 1 c0b175aa-0d93-11f1-9c9d-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=40644 Univerzitetni klinični center Ljubljana 0 0 0