Biomarkers have long played a key role in diagnosing HFwith NT-proBNP measurement combined with echocardiography widely adopted as a noninvasive diagnostic approach. In HFpEF, the utility of NT-proBNP is less clear than in HFrEF (HF with reduced ejection fraction) due to lower absolute elevations and the presence of multiple confounding factors. This evidence concerns the gene NPPB and hydrops fetalis.