Taken together with the recent findings of empagliflozin in patients hospitalized for acute HF33 and other evidence including the early initiation and continuation among survivors of acute myocardial infarction,28,31,34 we believed that early treatment of SGLT2 inhibitors may be effective for most populations with HF and any delay in therapy exposed patients to substantial excess risk. The gene discussed is SLC5A2; the disease is hydrops fetalis.