NPPB and hydrops fetalis: While GUIDE-IT did not demonstrate benefit in utilizing NP to guide HF therapies, more recently, STRONG-HF demonstrated that a strategy of rapid up titration of GDMT, as compared to those in the usual care, resulted in more patients with HF reaching target doses of these therapies and also lower NT-proBNP levels, and also incorporated modifications to GDMT titration schedule based on elevated NT-proBNP levels (32, 33).