We therefore focused on patients with normal EF without current or prior symptoms of overt HF, but at high risk for the condition for presence of T2D and allowing for arterial hypertension and structural (LV hypertrophy) or functional (diastolic dysfunction) or biochemical (NT-pro-BNP) evidence of initial myocardial disease (Stage A and B HF according to ACC/AHA guidelines). Here, NPPB is linked to hydrops fetalis.