However, in 178 patients with congestive heart failure (mean LVEF 47.5%) followed for 2 years, the combination of ROCK activity in PBMCs and N-terminal pro–B-type natriuretic peptide (NT-proBNP) at baseline provided additional value in assessing long-term survival as compared to levels of this natriuretic peptide alone (Dong et al., 2012), suggesting that ROCK activation is associated with progressive cardiac remodeling and consequently with the pathogenesis of worsening HF (Do et al., 2013). This evidence concerns the gene NPPB and hydrops fetalis.