SLC5A2 and hydrops fetalis: Therapy for HFrEF should include ARNI, a beta blocker, a MRA (finerenone if the patient has T2D and CKD with albuminuria; otherwise spironolactone or eplerenone), and a diuretic (if congestion is present).154,164 An SGLT2 inhibitor should also be included regardless of the presence of T2D, as these agents have shown benefit in patients with and without diabetes.40,119,120,124 HF clinical practice guidelines for device-based recommendations should be followed for patients with HFrEF.