Despite these results, subsequent trials have been controversial.In 2019, three important trials were published: the PARAGON-HF, the Comparison ofSacubitril/Valsartan Versus Enalapril on Effect on NT-proBNP in PatientsStabilized from an Acute Heart Failure Episode (PIONEER-HF), and the ProspectiveComparison of ARNI vs. Comorbidity-Associated Conventional Therapy on Quality ofLife and Exercise Capacity (PARALLAX) trials [63, 69, 70]. Here, NPPB is linked to hydrops fetalis.