Moreover, worse CFR values were seen to be associated with risk markers of HF severity, such as higher N-terminal pro–B-type natriuretic peptide [NT-proBNP] levels and evidence of RV dysfunction (assessed by tricuspid annular plane systolic excursion (TAPSE) and right ventricular free wall strain) (p < 0.05) [24]. This evidence concerns the gene NPPB and hydrops fetalis.