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Prof. Dr. John McMurray (Glasgow, Scotland, UK) discusses novel developments in the treatment of Heart Failure with reduced Ejection Fraction (HFREF) in the aftermath of th 2025 ESC Congress, focussing upon novel outcome data for vericiguat and digitoxin from the VICTOR and the DIGIT-HF study, respectively. Dr. McMurray is currently Professor of Medical Cardiology and honorary Consultant Cardiologist at the Queen Elizabeth University Hospital, Glasgow, UK. He served as the inaugural Eugene Braunwald Scholar in Cardiovascular Disease at the Brigham and Women’s Hospital, Boston, and visiting Professor of Medicine, Harvard University, Boston, Massachusetts USA. He is a Past-President of the Heart Failure Association of the ESC. He has been chairing the Task Force for 2012 ESC Guidelines on heart failure, and he was a member of the 2016 and 2021 Task Forces. The interview was recorded on September 22nd, 2025. Moderators: Prof. Dr. Florian Custodis (Saarbrücken, Germany), Prof. Dr. Dr. Stephan Schirmer (Kaiserslautern, Germany), Prof. Dr. Gunnar Heine (Frankfurt am Main, Germany). Articles discussed: Importance of Clinical Worsening of Heart Failure Treated in the Outpatient Setting: Evidence From the Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial (PARADIGM-HF). Okumura N, Jhund PS, Gong J, Lefkowitz MP, Rizkala AR, Rouleau JL, Shi VC, Swedberg K, Zile MR, Solomon SD, Packer M, McMurray JJ; PARADIGM-HF Investigators and Committees Circulation 2016 doi: 10.1161/CIRCULATIONAHA.115.020729 Vericiguat in patients with chronic heart failure and reduced ejection fraction (VICTOR): a double-blind, placebo-controlled, randomised, phase 3 trial. Butler J, McMullan CJ, Anstrom KJ, Barash I, Bonaca MP, Borentain M, Corda S, Ezekowitz JA, Felker GM, Gates D, Lam CSP, Lewis EF, Lindenfeld J, Mentz RJ, O'Connor CM, Ponikowski P, Reddy YNV, Rosano GMC, Saldarriaga C, Senni M, She L, Teixeira PP, Udelson J, Urbinati A, Vlajnic V, Voors AA, Xing A, Patel MJ, Zannad F; VICTOR Study Group Lancet 2025 doi: 10.1016/S0140-6736(25)01665-4 Digitoxin in Patients with Heart Failure and Reduced Ejection Fraction. Bavendiek U, Großhennig A, Schwab J, Berliner D, Rieth A, Maier LS, Gaspar T, Thomas NH, Liu X, Schallhorn S, Angelini E, Soltani S, Rathje F, Sandu MA, Geller W, Hambrecht R, Zdravkovic M, Philipp S, Kosevic D, Nickenig G, Scheiber D, Winkler S, Becher PM, Lurz P, Hülsmann M, Wiesner S, Schröder C, Neuhaus B, Seltmann A, von der Leyen H, Veltmann C, Störk S, Böhm M, Koch A, Bauersachs J; DIGIT-HF Study Group N Engl J Med 2025 doi: 10.1056/NEJMoa2415471 Vericiguat in Patients with Heart Failure and Reduced Ejection Fraction. Armstrong PW, Pieske B, Anstrom KJ, Ezekowitz J, Hernandez AF, Butler J, Lam CSP, Ponikowski P, Voors AA, Jia G, McNulty SE, Patel MJ, Roessig L, Koglin J, O'Connor CM; VICTORIA Study Group N Engl J Med 2020 doi: 10.1056/NEJMoa1915928 Efficacy and safety of low-dose digoxin in patients with heart failure. Rationale and design of the DECISION trial. van Veldhuisen DJ, Rienstra M, Mosterd A, Alings AM, van Asselt ADJ, Bouvy ML, Tijssen JGP, Schaap J, van der Wall EE, Voors AA, Boorsma EM, Lok DJA, Crijns HJGM, Schut A, Vijver MAT, Voordes GHD, de Vos AH, Maas-Soer EL, Smit NW, Touw DJ, Samuel M, van der Meer P; DECISION Investigators and Committees Eur J Heart Fail 2024 doi: 10.1002/ejhf.3428 Vericiguat Global Study in Participants with Chronic Heart Failure: Design of the VICTOR trial. Reddy YNV, Butler J, Anstrom KJ, Blaustein RO, Bonaca MP, Corda S, Ezekowitz JA, Lam CSP, Lewis EF, Lindenfeld J, McMullan CJ, Mentz RJ, O'Connor C, Patel M, Ponikowski P, Rosano GMC, Saldarriaga CI, Senni M, Udelson J, Voors AA, Zannad F Eur J Heart Fail 2025 doi: 10.1002/ejhf.3501 Long-term survival in severe heart failure in patients treated with enalapril. Ten year follow-up of CONSENSUS I. Swedberg K, Kjekshus J, Snapinn S. Eur Heart J 1999 doi: 10.1053/euhj.1998.1098 Angiotensin-neprilysin inhibition versus enalapril in heart failure. McMurray JJ, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR, Rouleau JL, Shi VC, Solomon SD, Swedberg K, Zile MR; PARADIGM-HF Investigators and Committees N Engl J Med 2014 doi: 10.1056/NEJMoa1409077 The effect of digoxin on mortality and morbidity in patients with heart failure. Digitalis Investigation Group N Engl J Med 1997 doi: 10.1056/NEJM199702203360801