The PARADIGM trial. The PARADIGM-HF (Prospective Comparison of ARNi with ACE Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure) Trial was conducted in 8,399 patients who had NYHA class II–IV HF and an LVEF of not more than 40% and who were randomly assigned to LCZ696 or enalapril3. The gene discussed is ACE; the disease is hydrops fetalis.