NPPB and pulmonary hypertension: However, also other conditions are associated with higher BNP levels: cardiac disease such as acute coronary syndrome, valvular heart disease [27], pericardial disease, atrial fibrillation [28], myocarditis, cardiac surgery and noncardiac ones such as renal failure [29], liver cirrhosis with ascites, pulmonary hypertension, and severe pneumonia.