Three trials recruiting patients with systolic dysfunction or elevated NT-proBNP succeeded in reducing mortality and HF development.22, 24 On the other hand, in one imaging-guided trial focusing on patients with preclinical LVDD who were randomised to treatment with an ACE-inhibitor and beta-blocker, or standard care, no reduction in HF events was observed.25 The gene discussed is NPPB; the disease is hydrops fetalis.