Due to a high variability of NT-proBNP levels in the absence of clinical change in HFpEF patients, previous studies have raised concerns the association between temporal trends in NT-proBNP disease worsening clinical status in HFpEF may not be observed or may not be as strong as in HFrEF. ¹⁰ We demonstrate a strong association between 6-month survival and the overall temporal trend in NT-proBNP values in both HFpEF and HFrEF patients. Up-trending NT-proBNP values are associated with worse 6-month survival in both subsets of HF. Conversely, downtrending NT-proBNP levels are associated with better 6-month survival rates.