NPPB and hydrops fetalis: Two landmark studies, the Comparison of Sacubitril-Valsartan vs. Enalapril on Effect of NT-proBNP in Patients Stabilized from an Acute Heart Failure Episode (PIONEER-HF) and the Prospective Comparison of ARNI and ARB Given Following Stabilization in Decompensated HFpEF (PARAGLIDE-HF) demonstrated that early initiation of sacubitril/valsartan (Sac/Val) led to a greater reduction in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in patients stabilized after AHF, especially in those with a left ventricular ejection fraction (LVEF) below normal.6–8