The study participants represented a typical outpatient cohort of HFpEF (Table 1): predominantly elderly patients (median age 68.7 years) with moderate functional limitations (58% had NYHA functional class II and 27% had functional class III), mild/moderate elevation of NT-proBNP (median 283 pg/mL), and multiple comorbidities (91% had overweight or obesity, 45% had paroxysmal AF, 41% had CKD, 40% had T2DM, and 35% had ischaemic heart disease). The gene discussed is NPPB; the disease is obesity due to melanocortin 4 receptor deficiency.