MME and hydrops fetalis: ,4 However, in 2014, the PARADIGM-HF (Prospective Comparison of angiotensin receptor-neprilysin inhibitor (ARNI) with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) study demonstrated that ARNI, specifically sacubitril/valsartan (SAV), was superior to ACEI over multiple important endpoints, including reducing cardiovascular (CV) death and HF hospitalizations.5