TIMP1 and hydrops fetalis: Similarly, a subanalysis of the PARAGON-HF (Prospective Comparison of ARNI With ARB Global Outcomes in HF With Preserved Ejection Fraction) trial demonstrated that treatment with sacubitril/valsartan led to a notable decrease in certain extracellular matrix degradation biomarkers, including TIMP-1 and PIIINP, when compared to valsartan alone after 16 months of follow-up [92].