In the Change the Management of Patients With Heart Failure (CHAMP-HF) registry of ambulatory HFrEF patients, 33% of eligible patients were not prescribed beta-blockers, 27% were not prescribed angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARBs), and 67% were not prescribed mineralocorticoid receptor antagonists (MRAs).2 The gene discussed is ACE; the disease is hydrops fetalis.