NPPB and Arrhythmia: Three recent works have specifically addressed the usefulness of bedside tissue Doppler echocardiography as well as its incremental role over the clinical judgment and BNP testing in the emergency diagnosis of acute HFPSF in patients hospitalized for acute severe dyspnea; this noninvasive method was found to be accurate, even among patients with inconclusive BNP levels (100–400 pg/ml) or arrhythmia [98-100].