Risk stratification of systolic HF patients is an important issue that can lead high-risk patients to invasive strategies New York Heart Association (NYHA) class, left ventricular ejection fraction (LVEF), B-type natriuretic peptide (BNP) level and peak exercise oxygen consumption (peak VO2) have been associated with the early death of HF patients2,3. Here, NPPB is linked to hydrops fetalis.