NPPB and hydrops fetalis: In this regard, we recently reported that Sacubitril/Valsartan affects lung diffusion capacity for carbon monoxide (DLCO) and lung mechanics; affects the release of the immature form of surfactant protein type B (proSP-B) from the alveolar-capillary membrane; and reduces the HF biomarkers, amino terminal pro-B-type natriuretic peptide (NT-proBNP) and soluble interleukin 1 receptor-like 1 (ST-2), suggesting the combined presence of hemodynamic and pleiotropic effects of the drug [4].