ibyago byo gupfa no gushyirwa mubitaro kubera kunanirwa k'umutima kurwego runaka.Nyamara, abarwayi bafite ibyago byinshi byo kunanirwa k'umutima bikabije, ibintu bipfa bikomeza kuba hafi 25% naho prognoz ikomeza kuba mibi.Kubwibyo rero, haracyakenewe byihutirwa imiti mishya yo kuvura mu kuvura HFrEF, na Vericiguat, imashini itera imbaraga ya guanylate cyclase (sGC), yakozwe mu bushakashatsi bwa VICTORIA kugira ngo harebwe niba Vericiguat ishobora kunoza imenyekanisha ry’abarwayi bafite HFrEF.Ubushakashatsi nubushakashatsi bwinshi, buteganijwe, bubangikanye-itsinda, bugenzurwa na perezidansi, impumyi ebyiri, ibyabaye-biterwa, icyiciro cya gatatu cy’ubuvuzi.Yayobowe n’ikigo cya VIGOR muri Kanada ku bufatanye n’ikigo cy’ubushakashatsi cy’ubuvuzi cya Duke, ibigo 616 byo mu bihugu n’uturere 42, birimo Uburayi, Ubuyapani, Ubushinwa na Amerika, bitabiriye ubwo bushakashatsi.Ishami ryacu ry'umutima ryatewe iteka no kwitabira.Umubare w'abarwayi 5.050 bafite ikibazo cy'umutima udakira ufite imyaka 18, NYHA icyiciro cya II-IV, EF <45%, hamwe na peptide natriuretic peptide (NT-proBNP) mu minsi 30 mbere yo gutoranywa, kandi bari bari mu bitaro kubera ikibazo cy'umutima. mugihe cy'amezi 6 mbere yo gutoranya cyangwa kuba diuretique yatanzwe mu mitsi kubera kunanirwa k'umutima mu mezi 3 mbere yo gutoranya abantu banditswe muri ubwo bushakashatsi, bose bakira ESC, AHA / ACC, hamwe n'amabwiriza yihariye y'igihugu / akarere yasabye ubuvuzi.Abarwayi batoranijwe mu kigereranyo cya 1: 1 n'amatsinda abiri hanyuma bahabwa Vericiguat (n = 2526) na placebo (n = 2524) hejuru yubuvuzi busanzwe.

Iherezo ryibanze ryubushakashatsi ni iherezo ryurupfu rwumutima nimiyoboro y'amaraso cyangwa ibitaro byambere byananiranye umutima;icyiciro cya kabiri cyarimo ibice bigize iherezo ryibanze, icyambere nicyakurikiyeho kunanirwa kumutima mubitaro (ibyambere nibisubirwamo), iherezo ryimpamvu zose zurupfu cyangwa kunanirwa kumutima mubitaro, hamwe nimpamvu zose zurupfu.Mu gihe cyo gukurikiranwa hagati y'amezi 10.8, habayeho kugabanuka ugereranije 10% mu ntangiriro y'urupfu rw'umutima n'imitsi cyangwa ibitaro bya mbere byananiranye mu bitaro mu itsinda rya Vericiguat ugereranije n'itsinda rya placebo.

Isesengura ry’imperuka ya kabiri ryerekanye ko igabanuka rikabije ry’ibitaro by’umutima (HR 0.90) no kugabanuka gukabije kwihererekanyabubasha ry’impfu zose cyangwa ibitaro by’umutima (HR 0.90) mu itsinda rya Vericiguat ugereranije nitsinda rya placebo.

Ibyavuye mu bushakashatsi byerekana ko kwiyongera kwa Vericiguat mu kuvura bisanzwe kunanirwa k'umutima bigabanya cyane ibintu biherutse kuba byatewe no kunanirwa k'umutima kandi bikagabanya ibyago byo guhitanwa n'urupfu rw'umutima n'imitsi cyangwa ibitaro kubera kunanirwa k'umutima ku barwayi barwaye HFrEF.Ubushobozi bwa Vericiguat bwo kugabanya ibyago byo guhitanwa nimpfu zumutima nimiyoboro yimitsi cyangwa ibitaro byumutima mubitaro kubarwayi bafite ikibazo cyumutima wumutima bitanga uburyo bushya bwo kuvura indwara zumutima kandi bugafungura inzira nshya zo gukora ubushakashatsi bwindwara zumutima.Vericiguat ntabwo yemerewe kwamamaza.Umutekano, imikorere myiza nigiciro cyibiyobyabwenge biracyakenewe kugeragezwa kumasoko.