The biology of adiponectin may vary in patients with heart failure (HF), specifically patients with preserved ejection fraction (HFpEF) (which comprises 50% of all HF), as most HFpEF patients are obese, causing the release of natriuretic peptides due to inflammation and myocardial stiffness in comparison with patients with reduced ejection fraction (HFrEF). Here, ADIPOQ is linked to hydrops fetalis.