ACE and hydrops fetalis: SV has demonstrated efficacy in reducing the risk of hospitalization due to HF in patients with chronic HFrEF and in patients hospitalized due to acute decompensation [20,21]. The PARADIGM-HF trial, comparing SV with angiotensin-converting enzyme inhibitor (ACEi) like enalapril, demonstrated a 20% relative risk reduction (RRR) in the primary composite endpoint of cardiovascular death or HF hospitalization.