The aim of this study was to evaluate whether changes in certain molecules involved in nucleocytoplasmic transport [Importin5 (IPO5), Nucleoporin153 kDa (NUP153), RanGTPase-Activating Protein 1 (RanGAP1)] and intramyocardial calcium homeostasis (SERCA2a) could be used to differentiate patients with advanced HF and MCS carriers from those with a greater clinical stability in whom elective transplantation could be performed without prior MCS intervention. Here, IPO5 is linked to hydrops fetalis.