Dapagliflozin, otherwise, showed in the Dapagliflozin Effect on Symptoms andBiomarkers in Patients With Heart Failure (DEFINE-HF) study an improvement inpatient-reported symptoms, physical limitations, and exercise function inpatients with HFpEF, compared to placebo (clinically meaningful improvement inKCCQ overall summary score or NT-proBNP levels 61.5% vs. 50.4%, adjusted OR1.8, 95% CI 1.03–3.06) [45]. This evidence concerns the gene NPPB and hydrops fetalis.