NPPB and diabetes mellitus: On the other hand, DiSomma et al.19 discovered that IL-18 in view of its ability to exert inflammatory, hypertrophic and pro-fibrotic activities stimulates BNP synthesis by cardiomyocytes in vitro studies and correlates with BNP in non-overloaded acute heart failure patients, and in patient with heart failure, diabetes mellitus, and CAD.