Recent advances in pharmacological therapies, including sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors), soluble guanylate cyclase stimulators (sGC stimulators), and cardiac myosin activators, have shown promise in HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF), offering mechanism-specific interventions. This evidence concerns the gene SGCB and hydrops fetalis.