ACE and hydrops fetalis: Its efficacy in reducing the combined risk of death from cardiovascular (CV) causes or hospitalization for HF was demonstrated in the PARADIGM-HF study [Prospective Comparison of ARNI with Angiotensin-Converting Enzyme Inhibitors (ACEI) to Determine Impact on Global Mortality and Morbidity in HF], a randomized, double-blind study involving 8,442 outpatients with symptomatic HF [New York Heart Association (NYHA) class II–IV] in patients with left ventricular ejection fraction (LVEF) ≤ 40% (5).