At 12th month of follow up, patients in automatic vs. echo group showed a significant reduction of NYHA class, BNP values (148.41 ± 16.40 vs. 197.26 ± 19.12 pg/ml, p 0.001), and inflammatory markers values, with higher values of 6MWT (319.37 ± 26.92 vs. 227.92 ± 28.19), significant reduction of left ventricle systolic diameters/volumes and mitral valve insufficiency (p < 0.05), and significant improvement of LVEF (36 ± 6 vs. 27 ± 5, p 0.001) Table 2. This evidence concerns the gene NPPB and mitral valve disorder.