NPPB and heart failure: In this regard, concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin I (hs-cTnI) are often elevated in HCM, with the degree of elevation associated with adverse outcomes, as well as heart failure symptoms and functional or structural anatomic abnormalities.4–9 These biomarkers are inexpensive and readily accessible in most clinical settings.