This trial was able to highlight the effect of ARNI therapy on novel biomarkers and indicates a superiority of sST2 to act as a biomarker for HF over GDF-15, H-FABP and suPAR with respect to multiple clinical parameters like LVEF, NT-pBNP, ESC Score, and MPI/Tei index. This evidence concerns the gene GDF15 and hydrops fetalis.