The most recent European Heart Association guidelines suggest some novel uses for cNP in HF with ejection fractions of 40–50 % and above 50 %, however, more data is needed to understand what the cut-off should be for this biomarker before introducing it into the risk charts, although based in the data of the STOP-HF trial American Guidelines recommended that BNP can be used as a screening tool for heart failure risk (25). This evidence concerns the gene NPPB and hydrops fetalis.