NPPB and hydrops fetalis: For example, changes in NT-proBNP levels in the phase II PARAMOUNT (Prospective comparison of ARNI with ARB on Management Of heart failure with preserved ejection fraction) trial8 predicted modest success in the phase III PARAGON-HF study (Prospective Angiotensin Receptor Antagonist Global Outcomes in Heart Failure), insofar as PARAGON-HF fell just short of meeting its primary endpoint.9