Activity in mitochondrial adenosine triphosphate synthesis determines cardioprotection and possible neuronal protection during ischemic insults; indeed, a significant decrease in circulating brain natriuretic peptide (BNP) levels has been observed, and this decrease has been positively correlated with improvements in clinical outcomes at 6 months in patients with congestive heart failure [99]. This evidence concerns the gene NPPB and congestive heart failure.