Tanshinone IIA sulfonate (TIIA) interacts hydrophobically with Keap1, facilitating its dissociation and degradation, thereby upregulating Nrf2 transcription and reducing H2O2-induced cardiomyocyte apoptosis (155), a meta-analysis of 14 RCTs confirmed its clinical efficacy as an adjunctive HF therapy (156). This evidence concerns the gene NFE2L2 and hydrops fetalis.