With reference to previous studies on the prognosis of HF (8–13), the aim of the present study was to determine prognostic incremental values for risk stratification of HF patients with reduced left ventricular ejection fraction (LVEF), with particular focus on the prognostic interactions of serum cholinesterase levels, renal function and cardiac sympathetic innervation as nutritional parameters. Here, BCHE is linked to hydrops fetalis.