Third, in this study, the presence of the biomarker combination has been analyzed by using the PICP and CITP:MMP1 medians rather than the cut-off points previously defined [4], since levels of PICP were lower and CITP:MMP1 values were higher in the patients here analyzed, suggesting the presence of a less severe myocardial fibrosis in terms of the quantity and quality of the collagen fiber as compared with the previously studied HF patients (including HFpEF and HF with reduced EF) [4]. This evidence concerns the gene MMP1 and hydrops fetalis.