In studies of patients with established heart failure, elevated levels of MR-proANP, MR-proADM and carboxy-terminal fragment of ET-1 (CT-proET-1) have been shown to be associated with mortality independently of clinical variables, and the biomarkers have displayed prognostic and discriminatory value that has compared favorably with BNP and/or NT-proBNP in the heart failure population [70–72]. This evidence concerns the gene NPPB and heart failure.