Empagliflozin in Heart Failure: Diuretic and Cardio-Renal Effects

Inclusion Criteria: * Stable HF as defined by: * No hospitalization for \>60 days * Stable HF medications for \>=2 weeks, and stable diuretics for 4 weeks * Opinion of HF cardiologist that the patient is at their optimal volume status * Chronic daily oral loop diuretic dose \>=20mg furosemide equivalents * Diagnosis of type II diabetes * Patient monitors blood glucose regularly at home * eGFR \>=45 mL/min/1.73 m2 * \>=18 years old Exclusion Criteria: * Active titration of chronic HF medications expected during the study period * Use of a non-loop diuretic, aside from an aldosterone antagonist (\<=25mg spironolactone or \<=50mg eplerenone) * Critical stenotic valvular disease, complex congenital heart disease, or prior heart transplant * History of diabetic ketoacidosis, "brittle" diabetes, and/or frequent hypoglycemia or severe hypoglycemic episodes requiring emergent intervention (ER visit or EMS response, glucagon administration or forced oral carbs) in the last 6 months * History of bladder dysfunction, incontinence, pyelonephritis, urosepsis, or frequent urinary tract infections * Anemia (defined as hemoglobin \<8g/dL) * Pregnancy or breastfeeding * History of serious hypersensitivity * Participation in another trial with an investigational drug within the 30 days prior to informed consent * Use of another SGLT-2 inhibitor * Appears unlikely, or unable to participate in the required study procedures, as assessed by the study PI or research RN (ex: clinically-significant psychiatric, addictive, or neurological disease) * Inability to give written informed consent or follow study protocol