B

Metoprolol (evidence-based β-blocker), sacubitril (ARNI) and nesiritide (IV recombinant BNP for acute decompensated HF) all have established roles in guideline-directed or acute management of heart failure [Rodgers, 2017, PMID 28285069; Dandamudi, 2012, PMID 22651831]. Trimetazidine is primarily an anti-anginal metabolic modulator; although small trials and meta-analyses have explored its use, it is not included in contemporary heart-failure treatment guidelines and is therefore not routinely used for this indication [Nassiri, 2024, PMID 38719498].