NPPB and chronic kidney disease: The conventional prognostic biomarkers of CHF include New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF), blood b-type natriuretic peptide (BNP) or N-terminal proBNP (NT-ProBNP), and influential comorbidities such as diabetes, chronic kidney disease and hypertension.2,3 Nevertheless, a significant number of patients with CHF cannot benefit from contemporary therapeutic strategies because of exclusion criteria based on current guidelines of heart failure management, cardiac device therapies, or no or minimal responses to therapies.