Heart failure & cardiomyopathiesCohort study
Effects of Vericiguat on the Mitochondrial Function and Clinical Outcomes in Cardiac Resynchronization Therapy (CRT) Nonresponders Patients
- multicenter, observational prospective study
Authors' conclusion
In this small cohort of CRT nonresponders, vericiguat increased CRT response at 1 year, likely through improved mitochondrial function and reduced inflammatory/oxidative stress. Larger studies are needed to confirm these findings.
Study context
- Population
- CRT nonresponderstreated with vericiguat 156 · non-treated 415
- Participants
- 156 vs 415
- Exposure
- CRT nonresponders treated with vericiguat vs non-treated
- vericiguat usersn = 156
- untreatedn = 415
- Outcome
- CRT responder rate (≥10% reduction in left ventricle end-systolic volume with improved functional status)
- Follow-up
- 1 year
Main finding
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
HF hospitalizations (secondary) · 1 year
| Outcome | Estimate |
|---|---|
| Predictors of CRT-responders outcome — vericiguat | 2.165 (95% CI 1.512–4.623) |
| Predictors of CRT-responders outcome — sacubitril/valsartan | 1.432 (95% CI 1.020–2.885) |
| Predictors of CRT-responders outcome — low-baseline ATP | 0.265 (95% CI 0.072–0.369) |
| Predictors of HF hospitalizations outcome · follow-up end — vericiguat · reduced | 0.312 (95% CI 0.195–0.497) |
| Predictors of HF hospitalizations outcome · follow-up end — sacubitril/valsartan · reduced | 0.672 (95% CI 0.308–0.865) |
| Predictors of HF hospitalizations outcome · follow-up end — lower baseline ATP production · increased | 4.881 (95% CI 1.945–8.507) |
| Predictors of HF hospitalizations outcome · follow-up end — left ventricular ejection fraction · increased | 1.864 (95% CI 1.209–2.871) |
- Heart failure (HF) hospitalizations (secondary): P < 0.05
NYHA functional class, left ventricular ejection fraction, inflammatory/oxidative stress levels · 1 year
- Better NYHA functional class, higher left ventricular ejection fraction, and lower inflammatory/oxidative stress levels with vericiguat
- P < 0.05
Mitochondrial function · 1 year
- Reduced methoxyisobutylisonitrile washout, enhanced adenosine triphosphate (ATP) synthesis, and increased sirtuins3-6 expression
- P < 0.05
Original publication
Effects of Vericiguat on the Mitochondrial Function and Clinical Outcomes in CRT Nonresponders Patients. JACC Adv. Published 4 April 2026. doi:10.1016/j.jacadv.2026.102708
Summarised from the published abstract; every number is checked against it