His ascites were determined to be cardiac in origin, resulting from congestive hepatopathy given the following: SAAG ≥ 1.1 g/dL, ascitic fluid total ≥ 2.5 g/dL, brain natriuretic peptide > 364 pg/dL, intact liver synthetic function, preexisting severe PAH, and physical signs of right heart failure. The gene discussed is NPPB; the disease is pulmonary arterial hypertension.