NPPB and hydrops fetalis: As previously reported, the great clinical benefit of sac/val has been demonstrated in the PARADIGM-HF trial (McMurray JJ, et al., 2014), however the positive effect of sac/val treatment in clinical practice is remarked, so as in our study, by the reduction in NT-proBNP levels, an important marker of cardiac remodelling, volume overload and haemodynamic instability.