In this study, we assessed the clinical predictors of altered chemosensitivity to hypoxia and hypercapnia in a cohort of systolic HF patients suggesting that chemoreflex, a critical pathophysiological determinant of HF progression and prognosis, may be predicted by using few clinical parameters easily obtainable and commonly assessed in whichever HF clinic: a blood withdrawal (NT-proBNP), a cardiopulmonary test (VE/VCO2 slope) and a short-term cardiorespiratory monitoring (diurnal PB). This evidence concerns the gene NPPB and hydrops fetalis.