In the two recent landmark randomised controlled trials (RCTs) conducted in patients with HF with mid-range ejection fraction (HFmEF) and HFpEF (HF and a left ventricular ejection fraction [LVEF] >40%; EMPEROR-Preserved and DELIVER), the inclusion criterion was NT-proBNP levels >300 pg/ml.18,19 In these patients, SGLT2 inhibitors significantly improved the combined endpoint of cardiovascular death and HF hospitalisations. This evidence concerns the gene NPPB and hydrops fetalis.