ACE and hydrops fetalis: For instance, in the CHAMP-HF registry, where the key inclusion criteria was an EF <40%, target doses were achieved in 18.7, 10.8, and 2% of the cohort for beta blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers and anti-neprolysin inhibitors, respectively, despite there being no contraindication or hypotension to prevent administration (12).