Nevertheless, a prospective design study containing 565 cases of sudden cardiac deaths (SCD) disclosed that even a subclinical volume and pressure overload triggers NT-proBNP and leads to an increased risk of SCD before the onset of clinical signs and symptoms of HF, also reflecting its prognostic value as a marker of myocardial injury and hemodynamic stress (65). This evidence concerns the gene NPPB and hydrops fetalis.