Parallax by Ankur Kalra

In this episode of Parallax, Dr Ankur Kalra is joined by Dr Michelle Kittleson, Professor of Medicine and Advanced Heart Failure Cardiologist at Cedars-Sinai Medical Center, for a clinically rich breakdown of her standout trial picks from the 2026 ACC Annual Scientific Sessions. Dr Kittleson brings her characteristic precision to four landmark studies spanning heart failure and atrial fibrillation. She unpacks the SPIRIT HF trial — a negative study of spironolactone in HFpEF that, she argues, does not consign the drug to the shelf — and explains why its high discontinuation rate and pandemic-era disruptions complicate the headline result. For clinicians managing cost-conscious patients, her take on spironolactone as a practical alternative to finerenone is a perspective worth hearing. The conversation turns to the CADENCE trial, a Phase 2 study of sotatercept in Group 2 pulmonary hypertension secondary to HFpEF — a phenotype Dr Kittleson treats with particular caution given the risks of misdirected pulmonar