{"id":"407438d8a54c","type":"article","url":"https://hartvaat.nl/2026/05/05/vericiguat-en-sgc-stimulatoren-bij-hartfalen-werkingsmechanisme-en-plaats-na-vic/","title":"Vericiguat en sGC-stimulatoren bij hartfalen: werkingsmechanisme en plaats na VICTORIA/VICTOR","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog"],"tags":["bloeddrukbehandeling","laminopathie","supraventriculaire-tachycardie","ventrikelfibrilleren","vericiguat"],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag117","source_url":"https://doi.org/10.1093/eschf/xvag117","authors":["Frank Ruschitzka","Robert Lukowski","Stefano Corda","Christian Meier","Peter Sandner"],"significance":6,"published":"2026-06-26","source_date":"2026-05-05","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/vericiguat-bij-hartfalen/","https://hartvaat.nl/kennis/hartfalen/betablokkers-bij-hartfalen/"],"congress":"","summary_en":"Review in ESC HF on the pharmacological rationale for soluble guanylyl cyclase (sGC) stimulators in chronic heart failure. Intact NO-sGC-cGMP signalling is essential to cardiovascular homeostasis; its impairment is regarded as a key pathomechanism in HF. The review describes the molecular mode of action of NO-independent, haem-dependent sGC stimulators and discusses preclinical and clinical evidence for broad cardiovascular effects, as well as effects on other organs that contribute to clinical outcomes. The sGC stimulator vericiguat has a place — on top of standard therapy — in adults with symptomatic HFrEF after a recent worsening event; this recommendation rests on the phase 3 VICTORIA and VICTOR trials. Outstanding research questions around vericiguat and related drugs are outlined.","created":"2026-07-03T10:33:07Z","updated":"2026-07-03T13:32:01Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Overzichtsartikel in ESC HF over de farmacologische gronden voor sGC-stimulatoren bij chronisch hartfalen. Intacte NO-soluble guanylyl cyclase (sGC)-cGMP-signalering is essentieel voor cardiovasculaire homeostase; verstoring ervan wordt beschouwd als een belangrijk pathomechanisme bij HF. De review beschrijft de moleculaire werkingswijze van NO-onafhankelijke, haem-afhankelijke sGC-stimulatoren en bespreekt preklinisch en klinisch bewijs voor brede cardiovasculaire effecten, evenals effecten op andere organen die bijdragen aan klinische uitkomsten. De sGC-stimulator vericiguat heeft een plaats — bovenop standaardtherapie — bij volwassenen met symptomatisch HFrEF na een recente decompensatie; deze aanbeveling rust op de fase 3 VICTORIA- en VICTOR-trials. Ook open onderzoeksvragen rondom vericiguat en verwante middelen worden geschetst.","abstract_original":"Despite recent advances in pharmacological treatment, chronic heart failure (HF) is associated with significant morbidity and mortality, and further treatment options are needed. Intact nitric oxide (NO)-soluble guanylyl cyclase (sGC)-cyclic guanosine monophosphate (cGMP) signalling is a prerequisite of cardiovascular health. cGMP produced by NO/NO-sGC acts as a second messenger molecule via various downstream targets, which influence a broad spectrum of critical physiological parameters. Impairment of this cascade in the cardiovascular system is considered an important pathomechanism in HF. This review examines pharmacological therapies that act through the NO-sGC-cGMP signalling pathway. We will focus on the molecular mode(s) of action of NO-independent but haem-dependent sGC stimulators, and will examine evidence from preclinical studies demonstrating cardiovascular benefits of these therapies and their increasing number of effects on other susceptible tissues and organs, which together could contribute to clinical outcomes in HF. The sGC stimulator vericiguat may be considered, in addition to standard therapy, for adults with symptomatic HF with reduced ejection fraction following a worsening event. The findings from pivotal clinical trials that led to these recommendations will be outlined and classified in terms of their significance for different subpopulations. These include the Phase 3 VICTORIA and VICTOR trials. Finally, further research areas and ongoing studies designed to address existing gaps in our knowledge regarding vericiguat and related drugs will be highlighted."}