The PARADIGM-HF (Prospective comparison of angiotensin receptor antagonist (Valsartan) and neprilysin inhibitor (Sacubitril) with angiotensin converting enzyme inhibitor (Enalapril) to determine impact on Global Mortality and Morbidity in Heart Failure) trial, has demonstrated that Sacubitril/Valsartan is superior to Enalapril in reducing the risks of both sudden cardiac death and death from worsening heart failure [37]. This evidence concerns the gene MME and hydrops fetalis.