Based on extensive and solid clinical evidence, a recent Consensus Statement of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) [11] detailed the importance of assessing the levels of cardiac biomarker N-terminal-pro B-type Natriuretic Peptide (NT-proBNP) to evaluate T2DM patients at risk of HF in pre-failure or “heart stress” (HS), a new term introduced to identify asymptomatic individuals with risk factors and elevated plasma NPs, irrespective of the presence or absence of structural heart disease or cardiac dysfunction. This evidence concerns the gene NPPB and hydrops fetalis.