Finally, in a Cox regression multivariate analysis that included age, sex, NT-pro-BNP, and significant TR, only NT-pro-BNP as a continuous variable (HR 1.00, 95% CI 1.00005 - 1.0002, p = 0.001) and significant TR (HR 2.23, 95% CI 1.12 - 4.42, p = 0.021) were independently associated with the composite endpoint of death or HF hospitalization. This evidence concerns the gene NPPB and hydrops fetalis.