NPPB and hyperemia: Compared to de novo AHF patients, AHF patients with worsening of CHF presented with markedly higher concentrations of NT-proBNP, a marker of heart congestion and elevated left-sided filling pressure10, indicating a more pronounced left ventricular dysfunction, accompanied by a lower MAP and higher SPAP and in turn, more severe right-sided HF with consequently more severe venous congestion.