NPPB and hydrops fetalis: NT-proBNP has further been evaluated as a means of guiding HF therapy in various studies with mixed results: The PROTECT study (2014) investigated whether lowering of NT-proBNP concentration (NT-proBNP guided therapy) led to an improvement in echocardiographic parameters when compared to standard of care management in 151 chronic HF patients with LV systolic dysfunction.