Thanks for your question on Health Care Magic.
I can understand your situation and problem.
By your history and description, possibility of congestive cardiac failure (CCF) is high.
Symptoms like coughing especially at night, not improving with inhaled treatment with
ejection fraction of 40% suggest cardiac failure more.
You are mostly having high BNP levels.
Along with head up position, you need
diuretic drugs.
Cardiac failure causes fluid retention in the body. So excess of fluid accumulates in the lungs and cause
Pulmonary edema.
Coughing is the earliest symptom of Pulmonary edema.
So you need diuretic and inotropic drugs.
Diuretics will increase urine output and reduce fluid overload.
Inotropic drugs will improve force of contraction of heart and fluid circulation in the body.
So consult your doctor and discuss about diuretics and inotropic drugs.
Hope I have solved your query.
Wish you good health. Thanks.