ACE and systolic heart failure: Despite this, the Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure (RALES) trial, the Eplerenone, a Selective Aldosterone Blocker, in Patients with Left Ventricular Dysfunction after Myocardial Infarction (EPHESUS) trial, and the Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms (EMPHASIS-HF) trial have demonstrated the efficacy of MRAs in HFrEF patients being treated with ACE inhibitors.