In previously published studies, natriuretic peptides and serum levels of biologically active adrenomedullin have been reported as possible markers of decongestion [28,29], and as already mentioned, one previously published study [13] showed that decreased VEGF levels are associated with a more severe degree of congestion in HF patients; however, as the data gathered so far are very limited, further research is definitely needed to confirm the possible role of VEGF as a marker of congestion in decompensated HF. This evidence concerns the gene ADM and hydrops fetalis.