36. Diuretics, ARNi, SGLT2/GLP1 therapies and iron for HFpEF with Dr. Robert Mentz

This episode addresses the complexities of managing Heart Failure with Preserved Ejection Fraction (HFpEF), focusing on practical strategies for decongestion and optimal loop diuretic use. Dr. Robert Mentz, Director of the Heart Failure Section at Duke, shares insights on titrating diuretics, transitioning between furosemide and torsemide, and the mechanistic benefits of each. The discussion covers the TRANSFORM-HF trial comparing these diuretics and emphasizes identifying decompensation causes and tailoring therapies to comorbidities like diabetes, for which SGLT2 inhibitors are beneficial. Dr. Mentz highlights the importance of shared decision-making, early outpatient follow-up, and managing iron deficiency in heart failure patients, while also addressing the impact of the COVID-19 pandemic on clinical trials.