Are mineralocorticoid receptor antagonists (MRAs) ready for prime time in HFpEF and HFmrEF?

In this special debate-format episode of the Heart Failure Beat, two leading heart failure pharmacists, Stormi Gale, PharmD, BCCP, FHFSA and Robert L Page II, PharmD, MSPH, FHFSA, go head-to-head on steroidal vs non-steroidal MRAs.

From RALES and TOPCAT to FINEARTS-HF, they unpack the evidence, guideline implications, cost-effectiveness, CKM considerations, and real-world barriers to access. Is finerenone the “new pillar” in HFpEF? Or does spironolactone remain the practical, evidence-based choice? The conversation also explores phenotyping challenges in HF trials and whether combining SGLT2 inhibitors with MRAs can attenuate hyperkalemia risk.

If you care about precision medicine, cardiorenal overlap, or optimizing GDMT in complex patients, this debate is for you.

Heart failure care is entering a new era - one defined not by singular devices, but by integrated systems of technology working together. In this episode, Laura Peters, DNP, joins The Heart Failure Beat to discuss a new joint HFSA + AAHFN scientific statement on integrated health technologies. From wearables and implantable devices to telehealth and AI, the conversation explores how systems-based approaches, patient engagement, and multidisciplinary teams can improve outcomes while reducing burden on clinicians.

For decades, sodium restriction has been treated as a cornerstone of heart failure self-care—despite limited trial-quality evidence. In this episode of Heart Failure Beat, Dr. Tariq Ahmad (Yale School of Medicine; Associate Editor, JACC: Heart Failure) joins hosts Michael Beasley, MD, and Priya Umapathi, MD, to unpack what we actually know about sodium targets in hospitalized and outpatient heart failure. They discuss why inpatient studies have been inconsistent, why a VA-commissioned review concluded sodium restriction for admitted HF patients is not supported, and how focusing on “dietary indiscretion” can distract from evidence-based priorities like GDMT. Dr. Ahmad also previews the pragmatic, EHR-embedded SOAR-AHF trial designed to compare regular vs low-sodium hospital diets and measure outcomes like length of stay and readmissions.

Priya Umapathi, MD speaks with six HFSA past presidents live from ASM 2025. Nancy M. Albert, PhD, CCNS, CCRN, NE-BC, Biykem Bozkurt, MD, PhD, Jim Fang, MD, FHFSA, Mark H. Drazner, MD MSc, Michael Felker, MD, FHFSA, and Ken Margulies, MD, FHFSA discuss their journeys, achievements, and the future of heart failure — from prevention to precision medicine and AI.

Guest editors Drs. Mak, Burkhoff, and Belkin join Heart Failure Beat to unpack the Journal of Cardiac Failure Hemodynamics Focus Issue. They discuss how renewed attention to pressure-volume loops, ECMO, and patient perspectives is reviving interest in hemodynamics as a vital foundation for heart failure care. Discover how simple physiological insights continue to drive complex innovations—and why now is the time to bring hemodynamics back to the center of cardiovascular practice. https://onlinejcf.com/current

Meet the editorial team behind JCF-Intersections, HFSA’s and the JCF Family of Journal’s new open-access journal. Drs. Jason Katz and Nosheen Reza share their vision for a journal that sits at the crossroads of heart failure and innovation. From unique article types to early-career mentorship, this is a must-listen for anyone in cardiovascular care. Listen now and read the debut issue of JCF-Intersections, out now at onlinejcfi.org.

In this episode of the Heart Failure Beat, Dr. Eric Adler of UC San Diego Health joins the show to discuss his landmark gene therapy trial for Danon disease, recently published in the New England Journal of Medicine. Dr. Adler recounts the powerful bedside-to-bench-to-bedside story that led to the development of a groundbreaking treatment for this severe, genetic cardiomyopathy. He explains the mechanics and evolution of gene therapy, its promise in treating monogenic heart failure syndromes, and the early but encouraging clinical outcomes—like dramatic reductions in troponins and heart mass. The episode also explores regulatory and safety challenges, delivery limitations, and the critical role of patient advocacy. Whether you’re a heart failure specialist or a translational researcher, this conversation offers compelling insights into the future of precision therapies in cardiology.

In this episode of Heart Failure Beat, Dr. Shashank Sinha—Medical Director of the CICU at Inova Fairfax—joins hosts Dr. Priya Umapathi and Dr. Michael Beasley to unpack the 2025 ACC Expert Consensus Statement on Cardiogenic Shock. Together, they explore the updated SHARC classification, staging systems, and the S.U.S.P.E.C.T. mnemonic for early recognition. Dr. Sinha shares practical insights on invasive hemodynamics, shock team composition, and new data on mechanical circulatory support. Plus, hear his “Top 10 Takeaways” for managing this complex and dynamic condition. Whether you work in a tertiary center or a community hospital, this episode delivers guidance for real-world care.