by Prateek Chopra | May 14, 2026 | Cardiology Conferences | ESC-HF 2026
The session highlighted that heart failure with reduced ejec on frac on (HFrEF) has entered a contemporary treatment era characterized by rapid and comprehensive implementa on of evidence-based therapies. Despite major advances with the four founda onal pillars, ACE inhibitors/ARNIs, beta-blockers, Mineralocor coid receptor antagonists, and SGLT2 inhibitors, many pa ents con nue to experience worsening heart failure and cardiovascular death. The objec ve was to define the current HFrEF treatment landscape and assess whether newer therapies, such as Vericiguat, can address residual risk in pa ents already receiving guideline-directed medical therapy (GDMT). The findings were presented at Heart Failure 2026, organized by the European Society of Cardiology, held in Barcelona, Spain, from 9–12 May 2026.
Key evidence from landmark randomized clinical trials was reviewed to summarize the evolu on of HFrEF treatment. Par cular a en on was given to the nitric oxide–soluble guanylate cyclase–cyclic guanosine monophosphate (NO–sGC–cGMP) pathway and its role in worsening heart failure. Clinical data from the VICTORIA and VICTOR programs, which enrolled more than 11,000 pa ents with worsening HFrEF, were evaluated. A representa ve clinical case was also used to illustrate prac cal treatment considera ons.
The analysis demonstrated that contemporary HFrEF management extends beyond the four founda onal therapies to include treatments that target persistent residual risk. Vericiguat was shown to restore signaling through the impaired NO–sGC–cGMP pathway and to reduce cardiovascular death or heart failure hospitaliza on in pa ents with recent worsening heart failure. The VICTORIA and VICTOR programs provided robust evidence suppor ng its role in this high-risk popula on.
It was concluded that the contemporary era of HFrEF is defined by early, comprehensive, and individualized use of multiple complementary therapies. In patients who continue to deteriorate despite optimized GDMT, addition of vericiguat may offer further reduction in adverse cardiovascular outcomes and help achieve a more complete treatment strategy.