However, several partially confounding factors, such as age, renal function, obesity and atrial fibrillation limit the accuracy of NT-proBNP and BNP as diagnostic and prognostic tests [97,98], thus, the identification of additional biomarkers for HF constitute an unmet need for further improvement in the accuracy of HF diagnosis and guidance of treatment. This evidence concerns the gene NPPB and atrial fibrillation.