NPPB and hydrops fetalis: These findings were then extended to the acute setting in the PIONEER-HF trial [3] (Comparison of Sacubitril-Valsartan vs Enalapril on Effect on NT-proBNP in Patients Stabilized from an Acute Heart Failure Episode), which included hemodynamically stable patients who were admitted to the hospital with a primary diagnosis of acute decompensated HF.