It is hypothesized that HF induces gut congestion and low-grade inflammation, which is thought to affect gut permeability leading to dysregulation of the microbiome and increased bacterial translocation.33 However, in our murine studies we did not observe differences in expression of the tight junction proteins or MUC2, suggesting that gut permeability was not affected by the HF model. This evidence concerns the gene MUC2 and hydrops fetalis.