njodzi yerufu uye kuchipatara nekuda kwekutadza kwemoyo kusvika pamwero.Nekudaro, varwere vari panjodzi huru yekudzokororwa kwemoyo kutadza kuwedzera zviitiko, kufa kunoramba kuri kwakatenderedza 25% uye kufungidzira kunoramba kuri kushoma.Naizvozvo, pachine kudiwa kwekukurumidzira kwevamiriri vatsva vekurapa mukurapwa kweHFrEF, uye Vericiguat, inova soluble guanylate cyclase (sGC) stimulator, yakadzidzwa muchidzidzo cheVICTORIA kuona kana Vericiguat inogona kuvandudza kufungidzira kwevarwere vane HFrEF.Chidzidzo chacho chakawanda, randomized, parallel-group, placebo-controlled, double-mapofu, chiitiko-chinotungamirirwa, chikamu chechitatu chekliniki yemigumisiro yekudzidza.Yakaitwa pasi pechirongwa cheVIGOR Center muCanada pamwe nekubatana neDuke Clinical Research Institute, nzvimbo dze616 munyika dze42 nematunhu, kusanganisira Europe, Japan, China neUnited States, vakapinda muchidzidzo ichi.Dhipatimendi redu rehutano hwemwoyo rakakudzwa kutora chikamu.Huwandu hwevarwere ve5,050 vane chirwere chemoyo chisingaperi vane makore ≥18 makore, NYHA kirasi II-IV, EF <45%, ine yakakwira natriuretic peptide (NT-proBNP) mazinga mukati memazuva makumi matatu isati yaitika, uye vaive muchipatara nekuda kwekukundikana kwemoyo. mukati memwedzi ye6 isati yaitwa randomisation kana kuti diuretics inoshandiswa intravenously nokuda kwekukundikana kwemoyo mukati memwedzi ye3 vasati vaita randomisation vakanyoreswa muchidzidzo, vose vachigamuchira ESC, AHA / ACC, uye nyika / nharaunda nhungamiro dzakakurudzirwa.Varwere vakarongeka muchiyero che1: 1 kumapoka maviri uye vakapiwa Vericiguat (n = 2526) uye placebo (n = 2524) pamusoro pehutano hwemazuva ose, maererano.

Mhedzisiro yekutanga yekudzidza yaiva iyo yakasanganiswa yekuguma kwekufa kwemwoyo kana kuti kutanga kwekushaya mwoyo kuchipatara;magumo echipiri aisanganisira zvikamu zvekutanga kwekupedzisira, kutanga uye kunotevera kurwara kwemoyo kuchipatara (zviitiko zvekutanga uye zvinowanzoitika), kuguma kwekupedzisira kwezvose-zvinokonzera rufu kana kuora mwoyo kuchipatara, uye zvose-zvinokonzera rufu.Pakutevedza kwepakati pemwedzi ye10.8, pakanga paine kuderedzwa kwe10% mumagumo ekutanga ekufa kwemoyo kana chirwere chekutanga chekushaya mwoyo muchipatara muboka reVericiguat zvichienzaniswa neboka re placebo.

Kuongororwa kwemashure ekupedzisira kwakaratidza kuderera kukuru kwekushaya mwoyo kuchipatara (HR 0.90) uye kuderera kukuru kwekupedzisira kwekupedzisira kwezvose-zvinokonzera rufu kana kushaya mwoyo kuchipatara (HR 0.90) muboka reVericiguat kana ichienzaniswa neboka re placebo.

Zvigumisiro zvechidzidzo zvinoratidza kuti kuwedzerwa kweVericiguat kuhutano hwehutano hwekushaya mwoyo kunoderedza zvakanyanya kuitika kwekupedzisira kwekuwedzera kwezviitiko zvekushaya mwoyo uye kunoderedza dambudziko rekupedzisira kwekupedzisira kwekufa kwemoyo kana kuchipatara nokuda kwekukundikana kwemoyo kune varwere vane HFrEF.Iko kukwanisa kweVericiguat kuderedza dambudziko rekupedzisira kwekupedzisira kwekufa kwemoyo kana kuparara kwemoyo muchipatara kune varwere vane njodzi huru yekukundikana kwemoyo inopa nzira itsva yekurapa kwekukundikana kwemoyo uye inozarura nzira itsva dzekutsvaga kwekutsvaga kwechirwere chemoyo.Vericiguat haisati yatenderwa kushambadzira.Kuchengetedzeka, kushanda nesimba uye kudhura kwemushonga kuchiri kuda kuongororwa pamusika.