In the study by Nagaya et al. [31] in a group of 60 patients with idiopathic PAH, baseline BNP level ≥180 pg/mL and its further increase during only 3 months of follow-up was associated with unfavorable outcomes, despite the use of prostacyclines in 82% of patients. This evidence concerns the gene NPPB and pulmonary arterial hypertension.