Prospective observational studies or randomized controlled trials comparing SV to placebo or ACE-inhibitor–based GDMT in patients with SSc-related HFrEF can be beneficial in determining the benefits in this specific patient population, with an emphasis on evaluating SV’s potential benefits for other disease manifestations, including Raynaud’s phenomenon, pulmonary arterial hypertension, RV systolic function, and scleroderma renal crisis. Here, ACE is linked to pulmonary arterial hypertension.