E/e’ in the range of 8–15 or high NT-pro B-type natriuretic peptide (NT-proBNP) levels (> 220 pg/ml; or BNP > 200 pg/ml) need to be accompanied by at least one additional sign of diastolic dysfunction, including a low E/A ratio combined with a high deceleration time, pulmonary venous flow patterns suggestive of diastolic dysfunction, high indexed left atrial volume, the presence of atrial fibrillation, and/or LV hypertrophy (Fig. 1). This evidence concerns the gene NPPB and atrial fibrillation.