NPPB and congestive heart failure: Patients with an exacerbation on the day of inclusion in the study were significantly older, had lower TAPSE, ang higher levels of NT-proBNP, SN and troponin T. The discrepancy in marker levels in relation to the clinical course suggests that SN is a dynamic cardiovascular marker that reflects clinical condition and the severity of hemodynamic instability rather than a chronic heart failure process.