After adjustment for age, gender, cardiovascular risk factors (hypertension, dyslipidemia, diabetes, coronary artery disease, smoke), atrial fibrillation, left ventricular ejection fraction, E/e’ ≥ 15 and admission BNP values, multivariable analysis confirmed prognostic power of ICV dilatation (HR 3.22 [1.58–6.55], p = 0.001) and clinical congestion score ≥ 2 (HR 2.35 [1.12–4.93], p = 0.023). This evidence concerns the gene NPPB and metabolic syndrome.