Finally, PALS showed a strong negative correlation with NYHA class and with NT-proBNP in acute and chronic HF; in fact, the use of PALS as an additive marker of congestion in HF is highly suggested, with the combination of global PALS and NT-proBNP significantly enhancing the prognostic stratification of HF [65,66]. Here, NPPB is linked to hydrops fetalis.