NPPB and heart failure: Further analysis revealed that patients with persistent ECG strain at 1 year following AVR had lower systolic and diastolic blood pressures (p = 0.017 and p = 0.040, respectively), greater QRS duration [102 ms (94–106.3) vs. 92 ms (86–101), p = 0.042], and more advanced heart failure, as evident by higher levels of BNP (p = 0.005) at baseline.