NPPB and hydrops fetalis: Furthermore, SGLT-2 inhibitors may also enhance cardiac efficiency by improving energy metabolism in cardiomyocytes, further reducing the end-diastolic ventricular volume.[41] BNP and NT-proBNP are peptide hormones secreted by the heart, are closely related to increased cardiac volume and pressure load, and serve as important biomarkers for HF diagnosis and prognosis assessment.[42] The significant efficacy of SGLT-2 inhibitors in HF treatment may be partially attributed to their regulation of BNP and NT-proBNP levels.