Ready, Set, Act! Opportunities to Address Persistent Unmet Needs in Patients With HFrEF: A Case-Based Discussion

Faculty: Carolyn Lam, MD, PhD


Faculty: Stephen J. Greene, MD

Using a real-world patient case, Dr. Stephen Greene and Dr. Carolyn Lam explore strategies to optimize care for patients with heart failure with reduced ejection fraction (HFrEF) who remain at elevated risk despite guideline-directed medical therapy (GDMT). The discussion examines the importance of avoiding clinical inertia, addressing persistent residual risk, and using biomarkers such as NT-proBNP to guide treatment decisions. Faculty also review the mechanism of action of the soluble guanylate cyclase stimulator vericiguat and evidence from the VICTORIA and VICTOR trials evaluating its use across a spectrum of ambulatory HFrEF populations, as well as findings from the VELOCITY study supporting a 5-mg starting dose and simplified titration to the target dose. Practical guidance is provided on integrating vericiguat with established HFrEF therapies, including patient selection, dosing, and tolerability, with the goal of reducing the risk of cardiovascular death and worsening heart failure in appropriate patients.