NPPB and heart failure: Currently, the FDA-approved indication for this therapy is heart failure in patients who remain symptomatic despite treatment guideline-directed medical therapy, are New York Heart Association Class III or Class II (with a recent history of Class III), have a left ventricular ejection fraction ≤ 35%, and have an NT-proBNP < 1600 pg/mL, excluding patients indicated for Cardiac Resynchronization Therapy according to American Heart Association/American College of Cardiology/European Society of Cardiology guidelines [56].