In these patients, increased natriuretic peptide (NP) levels (BNP >100 pg/ml or NT-proBNP >300 pg/ml) can be used as a diagnostic tool in addition to typical symptoms (dyspnea, peripheral edema, jugular vein distention, and fatigue), signs of cardiomegaly and lung congestion on chest radiography, and echocardiographic changes such as left ventricular hypertrophy, dilation, and diastolic dysfunction7,8. This evidence concerns the gene NPPB and left ventricular hypertrophy.