Applying the ESC 2019 diagnostic algorithm for HFpEF [12], our patient scored 6 points, supporting a diagnosis of HFpEF: functional domain: tricuspid regurgitation velocity of 3.0 m/second (major criterion, 2 points); morphological domain: severely elevated left atrial volume index (73.9 mL/m2, major criterion, 2 points); elevated left ventricular mass index (142 g/m2, minor criterion; and biomarker domain: NT-proBNP level of 752 pg/mL in the context of atrial fibrillation (major criterion threshold: >365 pg/mL in AF, 2 points). The gene discussed is NPPB; the disease is atrial fibrillation.