Úri et al[22] demonstrated that serum ACE2 activity had a diagnostic value in distinguishing heart failure with preserved ejection fraction (HFpEF) from heart failure with reduced ejection fraction (HFrEF) and it was associated with cardiovascular disease progression, ACE2 activity was significantly increased in hypertensive state and further increased in HFrEF but not in HFpEF when hypertension develops into HF. This evidence concerns the gene ACE2 and hydrops fetalis.