The Effect of Vericiguat on Peripheral Vascular Function, Patient Health Status and Inflammation

Inclusion Criteria: * History of chronic symptomatic HF (ACC/AHA Class C) and New York Heart Association (NYHA) Class II or III symptoms at the time of enrollment. * Left ventricular ejection fraction (LVEF) of ≤45% assessed within 12 months prior to randomization by any imaging method. * Systemic blood pressure ≥90/60 mmHg. * Standard guideline-directed HF therapy. * If female of reproductive potential, agrees to avoid becoming pregnant while receiving study drug and for 14 days after the last dose of study drug by complying with abstinence from heterosexual activity or use (or have her partner use) contraception during heterosexual activity. Exclusion Criteria: * Addition of a new disease-modifying HF pharmacotherapy or CRT-D in previous 4 weeks. * Current or anticipated use of long-acting nitrates or nitric oxide (NO) donors including isosorbide dinitrate, isosorbide 5-mononitrate, pentaerythritol tetranitrate, nicorandil or transdermal nitroglycerin (NTG) patch, and molsidomine. * Current or anticipated use of phosphodiesterase type 5 (PDE5) inhibitors such as vardenafil, tadalafil, and sildenafil. * Current use or anticipated use of a soluble guanylate cyclase (sGC) stimulator such as riociguat. * Known allergy or sensitivity to any sGC stimulator. * Estimated glomerular filtration rate (eGFR) \<15 mL/min/1.73 m2 or chronic dialysis. * Patients who are pregnant or breastfeeding or plan to become pregnant or to breastfeed.