PARADIGM-HF, a landmark clinical trial, found that sacubitril/valsartan is superior to angiotensin converting enzyme inhibitor (ACEI) in reducing hospitalizations and cardiovascular deaths in HF (McMurray et al., 2014; Myhre et al., 2019; Berg et al., 2020; Docherty et al., 2020). Here, ACE is linked to hydrops fetalis.