Dr Januzzi: A normal NT-proBNP for a middle-aged individual is 20 pg/mL or 30 pg/mL, maybe not much higher. If a patient presents with NT-proBNP of 300 pg/mL with shortness of breath, obesity and some oedema, it is very likely they have heart failure with preserved ejection fraction (HFpEF). Diagnosis in patients with HFpEF is a more challenging situation, where in addition to your physical exam, listening for gallop rhythms, listening to the lungs, reading the neck veins as well as echocardiography may be necessary for the diagnosis, they can be much more difficult and HFpEF is definitely a much more challenging population.
