The sub-analysis of PROVE-HF in HF patients with reduced EF revealed a significant increase in circulating ANP levels, which was associated with an improvement in cardiac remodeling [65]; however, Solomon et al. reported that sacubitril/valsartan did not improve the risk of death and rehospitalization in patients with preserved EF from the phase III PARAGON-HF trial [66]. Here, NPPA is linked to hydrops fetalis.