Objective: To exploring the clinical efficacy and safety of vericiguat in combination with the "new quadruple" for treating heart failure caused by dilated cardiomyopathy (DCM). Methods: Between December 1, 2022 and February 1, 2024, a total of 43 patients with heart failure resulting from dilated cardiomyopathy were consecutively recruited from the outpatient clinic and inpatient wards of the Cardiology Department at the First Affiliated Hospital of Nanjing Medical University. Among them, 33 were male and 10 were female, ranging in age from 30 to 76 years old, with a mean age of 46.7 years. Before enrollment, the patients' LAD, LVEF, LVEDD, NT-proBNP, liver and kidney function electrolytes, and Minnesota Heart Failure Life Quality Scale (MLHFQ) and 6MWT were measured. Patients with heart failure with reduced ejection fraction (HFrEF, LVEF ≤ 40%) and heart failure with mildly reduced ejection fraction (HFmrEF, LVEF 41% ~ 49%) were treated with vericiguat combined with "ARNI, BB, MRA, SGLT2i” new quadruple therapy. Patients with heart failure with preserved ejection fraction (HFpEF, LVEF ≥ 50%) are treated with vericiguat combined with "ARNI, BB, SGLT2i". The above indicators were rechecked after three months of treatment, and the LVEF, LVEDD, NT-proBNP, liver and kidney function, electrolytes and MLHFQ of the patients before and after treatment were compared. Results: For all DCM patients with heart failure, comparison after three months of treatment: LAD（41.37±6.97mm vs. 39.30±5.19, P<0.01）；LVEF（41.02%±10.33% vs. 46.43%±10.74%, P<0.01）；LVEDD（61.40±7.65mm vs. 58.56±7.03mm, P<0.01）；NT-proBNP（2003.59±2279.53ng/L vs. 808.86±1306.98ng/L, P<0.01）；MLHFQ（47.79±9.67vs. 34.86±8.94, P<0.01）；6MWT（348.85 ± 82.43 vs. 401.76 ±95.56, P<0.01）. There was no significant difference in liver and kidney function and electrolytes between patients before and after treatment. Further subgroup analysis showed that Vericiguat combined with "ARNI, BB, MRA, SGLT2i" improved the LVEF and reduced NT-proBNP levels in patients with HFrEF, HFmrEF or HFpEF heart failure caused by DCM. and improved patients' quality of life scores. Conclusion: Vericiguat combined with the "new quadruple" drugs has a significant therapeutic effect on patients with heart failure caused by DCM and the effect is obvious after three months’ treatment. This study provides potential data support and guidance for the treatment of DCM patients with clinical heart failure.