This should be considered when plasma concentrations of NT-proBNP are used as a diagnostic tool in obese patients, where diagnostic challenges might be present, since poor physical conditions due to obesity can mimic symptoms of HF and thereby increase the risk of misdiagnosis of HF with accurate and normal plasma concentrations of NT-proBNP. This evidence concerns the gene NPPB and obesity due to melanocortin 4 receptor deficiency.