The 2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure [5], as well as the 2022 AHA/ACC/HFSA Guidelines for the Management of Heart Failure [6], proposed ARNIs, beta blockers, SGLT2 inhibitors, and MRAs as a class IA first line therapy in the treatment of HFrEF (Table 1). The gene discussed is SLC5A2; the disease is heart failure.