A significant increase of OPN and Grem1 proteins expression in cardiomyocytes, already observed in the stage A HF (or at-risk for HF) group, was documented in our study by immunohistochemical analysis, continuing to increase in the stage B HF (or pre-HF) group, and achieving the peak expression in the stages C/D HF. Here, SPP1 is linked to hydrops fetalis.