The recent European Society of Cardiology (ESC) guidelines defined HFpEF as the presence of symptoms and/or signs of HF; preserved LVEF (LVEF > 50%); elevated levels of natriuretic peptide: brain natriuretic peptide (BNP) > 35 pg/mL and/or N-terminal pro-brain natriuretic peptide (NT-proBNP) > 125 pg/mL; and the evidence of diastolic dysfunction and/or structure heart disease (LV hypertrophy; left atrial (LA) enlargement) [6]. Here, NPPB is linked to hydrops fetalis.