What GDMT do you recommend for patients with AL amyloidosis and systolic heart failure?

You are correct that cardiac amyloidosis patients do not tolerate most of the GDMT. SGLT2i may be helpful for both diuresis as well as HFpEF, and we do try to start this. Generally, they do not tolerate ARB/ACEI or even beta blockers. We find that torsemide seems to have better GI absorption and thu...

Great question, and Dr. @Dr. First Last has provided a great answer. There are a few things that I will add to it.

Yes, late-stage cardiac amyloid patients are much more likely to be intolerant of GDMT, but this is a heterogeneous group that may or may not have comorbid CAD, arrhythmias, etc., and m...