No relevant studies comparing usual care with routine cardiac imaging were identified. The majority of the trials only included patients with HFREF as this is where the evidence base is for most of the treatments for HF.Treatment algorithms varied in the NP monitoring arm, some treated to an absolute NP target; others set a personal target based on percentage drop of NP levels; others did not aim to reduce NP levels, but used serial measurements to detect increases thought to represent deterioration and acted accordingly. The comparator arm involved treatment guided by protocol driven clinical monitoring in thirteen of fourteen studies. The comparator arm of one study and a third arm of two studies appeared to comprise of usual care that did not have a formal protocol for guiding treatment (described hereafter as no protocol ). The results are presented separately for the clinical monitoring and no protocol comparison arms because it was felt that any form of guided treatment was likely to have an effect on outcomes. The NP guided and clinically guided treatment arms were based in a specialist clinic in thirteen out of fourteen studies. The exception took place in primary care under general practitioners who had received training on how to use the monitoring protocols. One of the no protocol arms took place in a specialist clinic, and two were in primary care with no extra training. Study details and results were taken from the first available source in the following hierarchy. 