NPPB and systemic sclerosis: The diagnosis and management of patients with SSc-related MF is challenging: Current diagnostics to screen SSc patients for MF including echocardiography, electrocardiogram (ECG), and serum levels of N-terminal-probrain-natriuretic-peptide (Nt-pro-BNP) are not specific for MF and not sensitive for early changes [3, 9, 10].