Some postulated mechanisms of action of SGLT2 inhibitors that are beneficial in HF include their natriuresis and osmotic diuretic effects, which reduce the preload and afterload in HF [11], reduce the blood pressure [12,13], improve the cardiac metabolism and overall performance [14], preventing cardiac remodeling [15-17], and increase in erythropoietin levels with consequent improvement in myocardial tissue oxygenation [18]. This evidence concerns the gene EPO and hydrops fetalis.