Safety of Ataciguat in Patients With Moderate Calcific Aortic Valve Stenosis

Inclusion Criteria: * Age \> 50 years * Male or female sex * Aortic valve area greater than 1.0 cm2 but less than 2.0 cm2 * Aortic valve calcium levels greater than 300 arbitrary units from chest CT * Ejection fraction \>50% Exclusion Criteria: * History of orthostatic intolerance or symptomatic hypotension * Positive pregnancy test during screening visit * Nitrate use or α-antagonist medication use within 24 hours * Systolic blood pressure \<110 mm Hg * Mean systemic arterial pressure \<75 mm Hg * Severe mitral or aortic regurgitation * Retinal or optic nerve problems * Recent (≤30 days) acute coronary syndrome * Oxygen saturation \<90% on room air * Congenital valve disease * Hepatic dysfunction/elevated liver enzymes * Prescription of drugs known to alter nitric oxide-soluble guanylate cyclase-cyclic guanosine monophosphate signaling (sildenafil, nitrates, etc.) * History of orthostatic intolerance * Concomitant participation in other trials at Mayo Clinic or elsewhere.