The PIONEER-HF trial (Comparison of Sacubitril/Valsartan versus Enalapril on Effect on NT-pro BNP [N-terminal pro-B type natriuretic peptide] in Patients Stabilized from an Acute HF Episode) demonstrated that initiating sacubitril/valsartan treatment in patients stabilized during hospitalization for acute HF resulted in a greater reduction in NT-pro BNP concentration compared with the angiotensin-converting enzyme inhibitor (ACEI) enalapril [3]. Here, ACE is linked to hydrops fetalis.