NPPB and hydrops fetalis: Interestingly, during the 36 weeks follow-up in 301 patients with HFpEF in the PARAMOUNT-HF trial (15), NYHA class II–III and left ventricular EF ≥45%, demonstrated a significantly greater reduction in NT-proBNP from baseline to week 12, and in left atrial size at 36 weeks with sacubitril-valsartan than with valsartan.