Vericiguat and Reverse Remodeling Indices in Heart Failure

Inclusion Criteria: * Written informed consent from an adult patient (≥ 18 years old) to participate in the clinical study, * Stable HFrEF defined as no heart failure worsening in the 6 months before randomization that required hospitalization or outpatient diuretic treatment, * Confirmed diagnosis of chronic heart failure with reduced ejection fraction (LVEF \< 50%, confirmed by echocardiography) within 12 months before randomization, * Stable GDMT for HFrEF for at least 3 months prior to randomisation. Exclusion Criteria: * Systolic blood pressure \< 100 mmHg or symptomatic hypotension, * Current or planned use of long-acting nitrates, soluble guanylate cyclase stimulators, or phosphodiesterase type V inhibitors, * Known allergy/hypersensitivity to soluble guanylate cyclase stimulators, * Awaiting heart transplantation or dependence on continuous inotropic therapy * Cardiac amyloidosis, sarcoidosis, myocarditis, stress cardiomyopathy, or tachycardic cardiomyopathy, * Acute coronary syndrome, coronary artery bypass grafting, or percutaneous coronary intervention in the past three months before randomisation, * Long-term mechanical circulatory support of the left ventricle, * Active infection, * Chronic kidney disease stage 4 or 5, and * Advanced liver failure classified as Child-Pugh B or C.