NPPA and advanced heart failure: No significant differences were found in age, ejection fraction (EF) or left ventricular diastolic diameter (LVDD) between the two groups, and mRNA expression of the natriuretic peptides ANP and BNP was substantially upregulated in comparison to control myocardium samples (Table 1), indicative of activation of the embryonic/hypertrophic gene expression pattern consistent with advanced heart failure.