To this end, menopause-related estrogen decline, which is thought to contribute to the development of HF with preserved ejection fraction (HFpEF) and target organ damage [98, 99], is associated with elevated circulating inflammatory markers, such as tumor necrosis factor (TNF) α, interleukin 6 (IL-6) and plasminogen activator inhibitor-1 [100, 101]. Here, TNF is linked to hydrops fetalis.