Along with HF progression, multiple derangements in natriuretic peptide system occur, including a reduced expression of corin and furin leading to low biologically active peptides, an increased dipeptidyl-peptidase IV activity causing the rise in circulating levels of truncated pro-BNP and BNP, a downregulation of NPR-A and NPR-B, a desensitization of NPR-A/GC system and an increase NPR-C-mediated clearance [86]. This evidence concerns the gene NPR1 and hydrops fetalis.