C-reactive protein (CRP) is a measure of the response of the immune system and has demonstrated clinical significance in myocardial infarction. In heart failure, CRP has a similar relationship. The chicken or egg debate exists as to whether inflammation is caused by heart failure due to poor perfusion of the gut, resulting in microbiome translocation or if inflammation decreases, lymphatic function with a decrease in peripheral lymphatic compensation. CRP is elevated when brain natriuretic peptide (BNP) is elevated. The gene discussed is NPPB; the disease is heart failure.