The phase 2 Prospective comparison of ARNI (angiotensin receptor–neprilysin inhibitor) with ARB (angiotensin-receptor blockers) on Management Of heart failUre with preserved ejectioN fraction (PARAMOUNT) and the phase 3 Prospective Comparison of ARNI with ARB Global Outcomes in HF With Preserved Ejection Fraction (PARAGON-HF) trials randomized patients with HFpEF to sacubitril/valsartan or valsartan, showing that patients receiving sacubitril/valsartan had a greater reduction in hs-TnT compared to those assigned to valsartan (PARAMOUNT: 14%, p = 0.03; PARAGON-HF: 9%, p < 0.001) [68,69]. Here, MME is linked to hydrops fetalis.