Our study additionally delineated association between left atrial structure and function with age and NT-proBNP, concordant with the invasive hemodynamic findings of Melenovsky et al. Taken together, these results suggest that impairment in left atrial structure and function (reflecting increased hemodynamic stress and higher LV filling pressure) is prevalent and plays an important role in HF-pEF physiology. This evidence concerns the gene NPPB and peak expiratory flow.