Our study indirectly endorsed this pathway, as GDF-15 was significantly correlated with E/e’, which is not only an important echocardiographic hallmark reflecting increased LV filling pressures (presumably related to cardiac fibrosis) but also a marker of poor prognosis in HF, either individually or as part of more complex tissue Doppler-derived indexes [35]. This evidence concerns the gene GDF15 and hydrops fetalis.