NPPA and Abnormal autonomic nervous system physiology: More than 16 cardiokines have been identified, including atrial natriuretic factor (ANF), brain natriuretic peptide (BNP), transforming growth factor beta-1 (TGF-β1), angiotensin II, and proinflammatory cytokines such as IL-6 [32] which is associated with a decrease in heart rate variability, a hallmark of autonomic dysfunction during sepsis [33].