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Plasma surfactant protein-B: a novel biomarker in chronic heart failure

De Pasquale, Carmine G; Arnolda, Leonard; DOYLE, Ian R; Aylward, Phillip; Chew, Derek; BERSTEN, Andrew

Description

Background - in chronic heart failure (CHF), elevated pulmonary microvascular pressure (Pmv) results in pulmonary edema. Because elevated Pmv may alter the integrity of the alveolocapillary barrier, allowing leakage of surfactant protein-B (SP-B) from the alveoli into the circulation, we aimed to determine plasma levels of SP-B in CHF and their relation to clinical status. Methods and Results - Fifty-three outpatients with CHF had plasma SP-B and N-terminal proBNP (NT-proBNP) assayed, in...[Show more]

dc.contributor.authorDe Pasquale, Carmine G
dc.contributor.authorArnolda, Leonard
dc.contributor.authorDOYLE, Ian R
dc.contributor.authorAylward, Phillip
dc.contributor.authorChew, Derek
dc.contributor.authorBERSTEN, Andrew
dc.date.accessioned2015-12-07T22:51:04Z
dc.identifier.issn0009-7330
dc.identifier.urihttp://hdl.handle.net/1885/27290
dc.description.abstractBackground - in chronic heart failure (CHF), elevated pulmonary microvascular pressure (Pmv) results in pulmonary edema. Because elevated Pmv may alter the integrity of the alveolocapillary barrier, allowing leakage of surfactant protein-B (SP-B) from the alveoli into the circulation, we aimed to determine plasma levels of SP-B in CHF and their relation to clinical status. Methods and Results - Fifty-three outpatients with CHF had plasma SP-B and N-terminal proBNP (NT-proBNP) assayed, in addition to a formalized clinical assessment at each clinic review over a period of 18 months. The control group comprised 19 normal volunteers. Plasma SP-B was elevated in CHF (P<0.001), and levels increased with New York Heart Association classification (P<0.001). SP-B correlated with objective clinical status parameters and NT-proBNP. During follow-up, major cardiovascular events occurred in patients with higher plasma SP-B (P<0.01) and NT-proBNP (P<0.05). Furthermore, on conditional logistic regression analysis, only SP-B was independently associated with CHF hospitalization (P=0.005). The 53 patients underwent a total of 210 outpatient visits. When the diuretic dosage was increased on clinical grounds, SP-B had increased 39% (P<0.001) and NT-proBNP had increased 32% (P<0.001). Conversely, at the next visit, SP-B fell 12% (P<0.001), whereas NT-proBNP fell 39% (P<0.001). Conclusions - Plasma SP-B is increased in CHF, and levels are related to clinical severity. Furthermore, within individual patients, SP-B levels vary with dynamic clinical status and NT-proBNP levels. Because plasma SP-B is independently associated with CHF hospitalization, it may, by virtue of its differing release mechanism to NT-proBNP, be a clinically useful biomarker of the pulmonary consequences of raised Pmv.
dc.publisherLippincott Williams & Wilkins
dc.sourceCirculation Research
dc.subjectKeywords: amino terminal pro brain natriuretic peptide; biological marker; brain natriuretic peptide; loop diuretic agent; protein precursor; surfactant protein B; unclassified drug; adult; aged; alveolocapillary barrier; article; cardiovascular disease; clinical t Edema; Heart failure; Lung; Natriuretic peptides; Proteins
dc.titlePlasma surfactant protein-B: a novel biomarker in chronic heart failure
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume110
dc.date.issued2004
local.identifier.absfor110299 - Cardiovascular Medicine and Haematology not elsewhere classified
local.identifier.ariespublicationu4201517xPUB50
local.type.statusPublished Version
local.contributor.affiliationDe Pasquale, Carmine G, Flinders Medical Centre
local.contributor.affiliationArnolda, Leonard, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationDOYLE, Ian R, Flinders Medical Centre
local.contributor.affiliationAylward, Phillip, Flinders Medical Centre
local.contributor.affiliationChew, Derek, Flinders Medical Centre
local.contributor.affiliationBERSTEN, Andrew, Flinders Medical Centre
local.description.embargo2037-12-31
local.bibliographicCitation.startpage1091
local.bibliographicCitation.lastpage1096
local.identifier.doi10.1161/01.CIR.0000140260.73611.FA
dc.date.updated2015-12-07T12:24:10Z
local.identifier.scopusID2-s2.0-4844229374
CollectionsANU Research Publications

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