Cinaciguat is primarily used in the treatment of acute decompensated heart failure (ADHF) and pulmonary arterial hypertension (PAH). It works by activating soluble guanylate cyclase (sGC), an enzyme that plays a crucial role in regulating vascular tone and blood pressure. By enhancing sGC activity, cinaciguat promotes vasodilation, reducing the workload on the heart and improving blood flow. This makes it particularly beneficial in managing conditions where blood vessels are constricted or where the heart is under significant stress. Additionally, it has shown potential in addressing ischemia-reperfusion injury, a common complication following heart attacks or surgeries, by improving cardiac function and reducing tissue damage. Its application is still under research for broader therapeutic uses in cardiovascular diseases.