However, HF is a syndrome with a broad pathophysiological basis, and there is still need for novel circulating biomarkers that are expressed downstream several relevant molecular pathways.3 Recent examples of such novel HF biomarkers include ST2 (suppression of tumorigenicity 2)4 and galectin-3,5 which we have previously investigated and shown to provide additional information to that conferred by NT-proBNP. Here, NPPB is linked to hydrops fetalis.