The B-type natriuretic peptides are sensitive markers of ventricular dysfunction and are playing an increasingly important role in the diagnosis, management and prognosis of cardiac disease.1-5 Exercise has been shown to increase BNP secretion;6 in subjects with myocardial ischaemia this elevation is more pronounced and has been found to improve the diagnostic sensitivity of the exercise-stress ECG in a selected population with normal left ventricular ejection fractions.7,8. This evidence concerns the gene NPPB and heart disorder.