Gohar et al. [13] evaluated the diagnostic value of MR-proANP in a community cohort of men and women with newly suspected heart failure (HF) and reported that the addition of MR-proANP to a previously validated clinical model improved the c-statistic from 0.82 to 0.86, and with the addition of NT-proBNP, the c-statistic was 0.87, whereas the best exclusion cut-point for MR-proANP was 40 pmol/L, with a sensitivity of 0.99, specificity of 0.06, PPV of 0.30, and NPV of 0.92. Here, NPPA is linked to hydrops fetalis.