NPPB and hydrops fetalis: Comparison of Sacubitril-Valsartan versus Enalapril on Effect on NT-proBNP in patients Stabilized from an Acute Heart Failure Episode PIONEER-HF trial showed that, in patients with HF with reduced EF hospitalized for an acute decompensation, ARNIs improved health status, LV remodeling, and decreased N-terminal pro B-type natriuretic peptide (NT-proBNP) levels compared to enalapril [141].