Important regulatory pathways of cardiomyocyte metabolism include mTOR (mammalian target of rapamycin) and AMPK (AMP-activated protein kinase), which have a detrimental or cardioprotective effect on the heart, respectively.140,141 Furthermore, novel cardioprotective drugs targeting cell metabolism have been developed with strong cardioprotective effects in HF, including SGLT2is (sodium-glucose co-transporter-2 inhibitors) and GLP-1R (glucagon-like peptide-1 receptor) agonists. This evidence concerns the gene GLP1R and hydrops fetalis.