Finally, serum NRF-1 levels assessed according to NYHA functional classification suggest that the differential expression of NRF-1 observed across samples may be attributed to variations in the stages of HF among patients.<h4>Conclusions</h4>NRF-1 is a dynamically expressed molecule with cardioprotective properties that ameliorates HF and attenuates pyroptosis by inhibiting the caspase-1/GSDMD signaling pathway. Here, NRF1 is linked to hydrops fetalis.