HFA Congress 2026 — Dr Ambarish Pandey (University of Texas Southwestern Medical Center, Texas, US) joins us to discuss findings on diuretic resistance drawn from TRANSFORM-HF, a large-scale, pragmatic, randomised clinical effectiveness trial comparing torsemide versus furosemide in patients hospitalised with heart failure.

TRANSFORM-HF enrolled 2,973 patients across 60 US sites, randomising 1:1 to oral torsemide or furosemide prior to hospital discharge, with follow-up extending to 30 months. This analysis focuses on diuretic resistance within the trial cohort — examining its prevalence, clinical correlates, and impact on outcomes including all-cause mortality, hospitalisation, and quality of life across the two loop diuretic strategies.

Interview Questions:

1. How is diuretic resistance defined and identified in clinical practice, and why is it a particularly important problem to address in hospitalised heart failure patients?
2. What made the TRANSFORM-HF dataset well suited to examining diuretic resistance, and how was it characterised within this analysis?
3. What were your key findings regarding the prevalence and clinical profile of patients with diuretic resistance in the trial cohort?
4. How did diuretic resistance influence outcomes — including mortality, rehospitalisation, and quality of life — across the torsemide and furosemide arms?
5. Did torsemide demonstrate any advantage over furosemide specifically in patients with evidence of diuretic resistance?
6. What do these findings tell us about how loop diuretic choice should be informed by a patient's diuretic response profile?
7. What are the outstanding questions around managing diuretic resistance in heart failure, and what approaches show the most promise for future investigation?

Recorded on-site at Heart Failure Association Congress 2026, Barcelona.
Editors: Jordan Rance
Videographer: David Ben-Harosh, Oliver Miles
Support: This is an independent interview produced by Radcliffe Cardiology.