BNP is the most studied and widely used biomarker to manage and stratify patients with chronic HF; however, it has important limitations concerning interpretation in patients with atrial fibrillation, obesity, and renal dysfunction.27 More recently proposed biomarkers such as soluble suppression of tumorigenicity 2 (sST2),28 growth differentiation factor 15 (GDF-15),29 and galectin-330 have been proven to portend prognostic information in HF but are still not widely available. The gene discussed is NPPB; the disease is obesity due to melanocortin 4 receptor deficiency.