NPPB and chronic obstructive pulmonary disease: The rise of brain natriuretic peptide (BNP) continues after admission to the hospital for AECOPD, and a minority of patients have clinically significant troponin rises. The elevations in cardiac biomarkers were associated with nebulized beta2 agonists. Suggesting that a high dose of beta2 agonists could increase cardiac dysfunction in COPD patients.