NPPA and myeloid sarcoma: In a study by Nakamura et al. on 14 patients with severe MS undergoing PTMC, plasma ANP levels decreased significantly after PTMC yet plasma BNP levels remained unchanged at both 0.5 and 24 hours after the procedure.11 On the other hand, Esteves et al. describe a significant decrease in plasma BNP 24 hours postvalvuloplasty on their cohort of 30 severe MS cases undergoing PTMC and report the decrease in LAP as the only predictor of a BNP levels decrease.12 In one study cardiac rhythm was suggested to play a possible role in BNP changes following PTMC.