On the one hand, this could be caused by the fact that NT-proBNP levels are highly dynamic and might thus not reflect the severity of chronic atrial remodelling.54,55 On the other hand, NT-proBNP levels are not only determined by myocardial wall stress but also influenced by, e.g. age, sex, kidney function, diabetes, and BMI,56–58 which probably prevents a correlation between NT-proBNP levels and measurements of disturbed Na homeostasis in our study. The gene discussed is NPPB; the disease is diabetes mellitus.