Gal-4, a transporter of apical proteins such as protease dipeptidyl peptidase-4,46 has been shown to be linked with an increased risk of incident HF47 as well as increased risk of adverse events in severe HF48 and HF with obesity and diabetes in recent studies.46 The other members of the galectin family are associated with the inflammatory immune response in cardiovascular metabolic diseases; however, studies on Gal-4 are limited, and further research is warranted to elucidate its role in fibrosis and congestion in HF. The gene discussed is LGALS4; the disease is hydrops fetalis.