We suspect that the higher mortality in the group with increasing BNP at discharge may be attributed to the lower grade of decongestion whether due to inefficient diuresis, vasodilation, and renin–angiotensin–aldosterone system inhibition or, more importantly, due to worse underlying HF pathology, compared with those with an admission-to-discharge BNP reduction. The gene discussed is NPPB; the disease is hydrops fetalis.