In contrast, ANP or BNP infusion, while leading to improvement in measures of HF, has been linked to an increased risk of side-effects related to hypotension or nephrotoxicity [86,87,88], supporting the concept that off-target effects of direct infusion of natriuretic peptides are less desirable than methods to boost their intrinsic local concentrations and effects. Here, NPPB is linked to hydrops fetalis.