In a propensity score–matched retrospective cohortstudy of 1038 pediatric HF patients from the TriNetX database,sacubitril-valsartan was not associated with a reduction in 1-year all-causemortality or heart transplantation compared to ACE/ARB therapy (13.3% vs 13.2%,p = 0.95). This evidence concerns the gene ACE and hydrops fetalis.