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. The gene discussed is NPPB; the disease is obesity due to melanocortin 4 receptor deficiency.