Which of the following is listed as diuretic therapy for HFmrEF?

• A. RASS blockade
• B. MRAs
• C. Diuretics
• D. SGLT2 inhibitors

Answer: (C)

Relief of congestion is the main purpose of diuretic therapy in HFmrEF. Diuretics reduce fluid buildup by increasing urine output, which lowers preload and eases edema and pulmonary or systemic congestion. This translates into fewer symptoms like shortness of breath and better exercise tolerance, and can reduce hospitalizations when used to achieve euvolemia. They provide symptomatic benefit rather than altering the underlying disease process.

The other therapies listed target different mechanisms. RASS blockade (like ACE inhibitors or ARBs) and MRAs reduce harmful neurohormonal activation and have mortality/m morbidity benefits in heart failure. SGLT2 inhibitors also improve outcomes across HF phenotypes, including HFmrEF, but they’re not classified as diuretics. In the context of “diuretic therapy,” the labeled option is the diuretic class used to manage fluid overload.