A 58-year-old man with a 3-year history of systolic heart failure (LVEF 28%) on enalapril, metoprolol, and spironolactone presents with progressive dyspnea, orthopnea, and peripheral edema over 2 weeks. Vital signs: BP 110/70 mmHg, HR 92/min, RR 22/min, JVP 8 cm H₂O. Chest X-ray shows bilateral pulmonary edema. NT-proBNP is 2800 pg/mL. Echocardiography confirms LVEF 25%. He denies chest pain or syncope. What is the most appropriate next step in management?

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