The simultaneous increase in the expression of tropoelastin (a precursor molecule of elastin) and Loxl1 may lead to the cross-linking and subsequent accumulation of elastin in advanced HF, and by the time of cirrhosis, the overaccumulation of elastin may bind to the collagen scaffold, thereby promoting collagen fibers into a more contractile state and leading to increased HF(Chen et al., 2019). Here, ELN is linked to hydrops fetalis.