Regardless of the cause of DCM, the progression from asymptomatic to symptomatic HF is associated with interdependent, neurohormonal alterations of the sympathetic nervous system (SNS), the renin–angiotensin–aldosterone system (RAAS), and the natriuretic peptide (NP) system [9,10,11,12,13]. This evidence concerns the gene REN and hydrops fetalis.