Recently, clinical trials showed that sacubitril/valsartan was superior to angiotensin converting enzyme inhibitor (ACEI) in improving outcomes of HF patients with reduced ejection fraction (HFrEF) (PARADIGM-HF trial)15 and lowering N-terminal pro-B-type natriuretic peptide in patients hospitalized due to acute decompensated HF16. The gene discussed is ACE; the disease is hydrops fetalis.