—group B – 21 patients with symptomatic HF (stage C) and advanced HF with reduced EF (stage D); all patients in this group were New York Heart Association classes III and IV, having had a recent (in the past month) significant HF hospitalization; they were analyzed when free of systemic congestion, but significantly elevated natriuretic peptides were still documented (mean value for NT-proBNP 3326 +/– 192 pg/ml). The gene discussed is NPPB; the disease is hydrops fetalis.