·      In HFpEF patients with specific selection criteria like phenogroup 3 from the TOPCAT sub-study (and with EF >45%, elevated BNP levels or HF admission within 1 year, estimated glomerular filtration rate >30 mL/min, creatinine <2.5 mg/dL, potassium <5.0 mEq/L), aldosterone receptor antagonists such as spironolactone or eplerenone may be considered to decrease hospitalizations. Here, NPPB is linked to hydrops fetalis.