AlthoughN-terminal pro-B-type natriuretic peptide (NT-proBNP) has been established as apredictor of progression in HFpEF, NT-proBNP may be normal in patients with HFpEFand influenced by presence of atrial fibrillation, renal dysfunction and obesity[85]. The gene discussed is NPPB; the disease is obesity due to melanocortin 4 receptor deficiency.