NPPB and hydrops fetalis: We must point out two issues regarding the effect of sacubitril/valsartan on NT-proBNP concentrations: the precocity, few days in the TRANSITION post-hoc analysis, 1 week in PIONEER-HF and 4 weeks in PARADIGM, reflecting a rapid decrease of myocardial wall stress; and the close association with a lower risk of adverse clinical events, reflecting the meaningful relationship between cardiac protection and clinical evolution.