When FAO is limited, the concentrations of C4OH-carnitine, C2-carnitine, and succinate in myocardial tissues increase, suggesting that the activation of oxidation pathways of KBs increases [5], which is usually observed in cardiometabolic remodelling in individuals with HF and is associated with increased expression of ketolytic enzymes such as BDH1 [7]. The gene discussed is BDH1; the disease is hydrops fetalis.