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Although the prognosis has recently improved, it remains a lethal disease, with a mortality that equals or exceeds that of many malignancies. Furthermore, chronic <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content> is costly, representing a large and growing drain on healthcare resources.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This narrative review is based on the material searched for and obtained via PubMed up to May 2017. The search terms we used were as follows: \u201cheart failure, echocardiography, natriuretic peptides\u201d in combination with \u201ctreatment, biomarkers, guidelines.\u201d<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Recent studies have supported the value of natriuretic peptides (<jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content>s) and Doppler echocardiographic biomarkers of increased left ventricular (<jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>) filling pressures or pulmonary congestion as tools to scrutinize patients with impending clinically overt <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>. Therefore, combination of pulsed\u2010wave tissue and blood flow Doppler with <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content>s appears valuable in guiding <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content> management in the outpatient setting. In as much as both the echo and the plasma levels of <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content>s may reflect the presence of fluid overload and elevations of <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> filling pressures, integrating <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content> and echocardiographic biomarkers with clinical findings may help the cardiologist to identify high\u2010risk patients, that is to recognize whether a patient is stable or the condition is likely to evolve into decompensated <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>, to optimize treatment, to improve the prognosis and to reduce rehospitalization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We discussed the rationale and the clinical significance of combining follow\u2010up echo and <jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content> assessment to guide management of ambulatory patients with chronic <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.12846","type":"journal-article","created":{"date-parts":[[2017,10,16]],"date-time":"2017-10-16T20:07:18Z","timestamp":1508184438000},"source":"Crossref","is-referenced-by-count":13,"title":["Combining echo and natriuretic peptides to guide heart failure care in the outpatient setting: A position paper"],"prefix":"10.1111","volume":"47","author":[{"given":"Frank L.","family":"Dini","sequence":"first","affiliation":[{"name":"Cardiovascular and Thoracic Department University of Pisa Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erberto","family":"Carluccio","sequence":"additional","affiliation":[{"name":"Divisions of Cardiology School of Medicine University of Perugia Perugia 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