The prognosis of patients with HF and reduced ejection fraction (HFrEF) has improved considerably since the introduction of recent HF therapies, including β-blockers, angiotensin-converting enzyme inhibitors (ACEs)/angiotensin receptor neprilysin inhibitors (ARNIs), mineralocorticoid receptor antagonists (MRAs), sodium-glucose co-transporter 2 inhibitors (SGLT2is) and intravenous iron administration2. This evidence concerns the gene ACE and hydrops fetalis.