The Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure (ARISE-HF) Trial [24] is a global phase 3 randomized study evaluating the safety and efficacy of two doses of a novel highly-selective aldose reductase inhibitor (AT-001) versus placebo to improve or prevent decline in functional capacity in individuals with DbCM. Here, AKR1B1 is linked to hydrops fetalis.