NPPB and hydrops fetalis: An intensive and accelerated up-titration of GDMTs is currently recommended to improve post-AHF outcomes.3–5 However, up-titration to the max dose of Sac/Val was infrequent (13.6%) in the PREMIER study, compared with previous PIONEER-HF (55.2%) and PARAGLIDE-HF (39.1%) trials.6,7 Nevertheless, a favourable NT-proBNP response to Sac/Val therapy was observed in the present study.