In a comprehensive analysis of the GUIDE-IT (Guiding Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure) trial that included 638 patients with HF with reduced ejection fraction, patients achieving an NT-proBNP level ≤ 1,000 pg/mL by 90 days after randomization was associated with significantly better clinical outcomes and better quality of life that those that did not [2]. The gene discussed is NPPB; the disease is hydrops fetalis.