In this direction, according to a post-hoc analysis of the VICTORIA trial [37], patients with very high levels of NT-proBNP (here defined as levels over the 75th percentile; meaning > 5314 pg/ml) suffer probably from a far too advanced and/or destabilized HF as well as many comorbidities to derive benefit from vericiguat (Fig. 5). This evidence concerns the gene NPPB and hydrops fetalis.