BNP was significantly higher in the patients with echocardiographic features consistent with heart failure, although in both groups the median BNP was lower than that seen in acute heart failure, and even in those with echocardiographic features consistent with heart failure the median BNP was similar to the cut-off proposed for ruling out heart failure in acutely breathless patients or untreated clinic patients (29pmol/l) [12]. This evidence concerns the gene NPPB and heart failure.