NPPB and heart failure: A study by yin meng et al. included 75 patients with HF and SCH, which revealed there was an increase in the level of brain natriuretic peptide (BNP) with SCH, suggesting that SCH can be taken as a comorbidity of heart failure resulting in diastolic dysfunction, E/E′ ratio (the peak velocity of blood flow across the mitral valve in early diastole/the mitral annular velocity in early diastole ratio) was also found higher in SCH group in comparison to the euthyroid group [12].