FWIW...I am a CHF patient as well. I was put on Orgovyx/Nubeqa with concurrence from my Cardio-Oncologist after consult with my Genito-Urinary Oncologist.

From the below linked article, "Recent data reinforces that GnRH antagonists have a more favorable cardiovascular outcomes compared to GnRH agonists yet maintain a similar efficacy profile."

The studies referenced in the article, and the article itself, along with an echo EF of 30-35%, were used for pre-auth to get my insurance company to cover it.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8254069/
Best wishes!