Cinaciguat (BAY 58-2667) is an experimental drug for the treatment of acute decompensated heart failure. Cinaciguat (BAY 58-2667) is an experimental drug for the treatment of acute decompensated heart failure. Cinaciguat activates the soluble guanylate cyclase (sGC) which is a receptor for nitric oxide. This increases biosynthesis of cyclic GMP, resulting in vasodilation.