NPPB and hydrops fetalis: In the past, systematic reviews have examined the effects of trimetazidine in HF (online supplemental table A4).10–15 However, there was a focus on surrogate endpoints (eg, LVEF or HF biomarkers/N-terminal pro b-type natriuretic peptide or NT-proBNP), and at most 11 studies were included focusing on clinically relevant endpoints.