More recently, the PIONEER-HF [Comparison of Sacubitril/Valsartan vs. Enalapril on Effect on N-terminal pro b-type natriuretic peptide (NT-proBNP) in Patients Stabilized from an Acute HF Episode] and TRANSITION [Comparison of Pre- and Post-discharge Initiation of Sacubitril/Valsartan Therapy in HF With Reduced Ejection Fraction (HFrEF) Patients After an Acute Decompensation Event] trials demonstrated that early administration of sacubitril/valsartan during hospitalization improves prognostic markers and reduces the risk of rehospitalization relative to enalapril (7, 8). The gene discussed is NPPB; the disease is hydrops fetalis.