Circulating surfactant protein-B levels increase acutely in response to exercise-induced left ventricular dysfunction

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dc.contributor.authorDe Pasquale, Carmine G
dc.contributor.authorArnolda, Leonard
dc.contributor.authorDOYLE, Ian R
dc.contributor.authorAylward, Phillip
dc.contributor.authorRussell, Andrew
dc.contributor.authorBERSTEN, Andrew
dc.date.accessioned2015-12-07T22:54:05Z
dc.date.issued2005
dc.date.updated2015-12-07T12:46:22Z
dc.description.abstractAs a result of its enormous surface area and necessary thinness for gas exchange, the alveolocapillary barrier is vulnerable to mechanical disruption from raised pulmonary microvascular pressure (Pmv). Because surfactant protein-B (SP-B) leaks into the blood stream from the alveoli in response to alveolocapillary barrier damage and exercise leads to increased Pmv, we sought to determine whether exercise results in increased plasma SP-B. Moreover, in the setting of exercise-induced left ventricular dysfunction, the consequent increase in left heart filling pressure and, therefore, Pmv would be expected to further increase plasma SP-B levels. Twenty consecutive subjects referred for treadmill exercise stress echocardiography (ESE) had venous blood sampled immediately before and after ESE for batch atrial natriuretic peptide (ANP) and SP-B assay. Echocardiographic measures of pulmonary haemodynamics (pulmonary artery flow acceleration time (pafAT) and right ventricular outflow tract velocity time integral (rVTI)) were also taken pre- and post-exercise. Although circulating ANP levels increased following exercise (P < 0.001), there was no change in circulating SP-B levels in the entire cohort. Ten subjects had a positive ESE for ventricular dysfunction. Although circulating ANP was increased post-exercise in both the negative and positive ESE groups (P < 0.05 and P < 0.01, respectively), circulating SP-B only increased post-exercise in the positive ESE group (P < 0.05). Echocardiographic parameters supported an increment in Pmv in the cohort with exercise-induced left ventricular dysfunction because this group had an increase in pafAT (P < 0.05; reflecting pulmonary artery pressure) and no change in rVTI. Physical exertion associated with a Bruce protocol ESE is insufficient to increase circulating SP-B, despite evidence of increased left atrial and pulmonary vascular pressure. However, in the setting of exercise-induced myocardial dysfunction, there is a detectable increase in circulating SP-B. The exaggerated increase in pulmonary vascular pressure in exercise-induced myocardial dysfunction may result in increased SP-B leakage from the alveoli into the circulation by altering the integrity of the alveolocapillary barrier to protein.
dc.identifier.issn0305-1870
dc.identifier.urihttp://hdl.handle.net/1885/28016
dc.publisherBlackwell Science Asia
dc.sourceClinical and Experimental Pharmacology and Physiology
dc.subjectKeywords: atrial natriuretic factor; surfactant protein B; adult; artery blood flow; article; blood pressure; capillary permeability; clinical article; controlled study; Doppler echocardiography; female; flow rate; heart function; heart left atrium pressure; heart Atrial natiuretic peptide; Capillary fragility; Capillary permeability; Echocardiography; Exercise test; Pulmonary circulation; Surfactant protein-B; Ventricular pressure
dc.titleCirculating surfactant protein-B levels increase acutely in response to exercise-induced left ventricular dysfunction
dc.typeJournal article
local.bibliographicCitation.startpage622 627
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.affiliationRussell, Andrew, Veterans Heart Clinic
local.contributor.affiliationBERSTEN, Andrew, Flinders Medical Centre
local.contributor.authoremailu4719326@anu.edu.au
local.contributor.authoruidArnolda, Leonard, u4719326
local.description.embargo2037-12-31
local.description.notesImported from ARIES
local.identifier.absfor119999 - Medical and Health Sciences not elsewhere classified
local.identifier.ariespublicationu4201517xPUB55
local.identifier.citationvolume32
local.identifier.doi10.1111/j.0305-1870.2005.04241.x
local.identifier.scopusID2-s2.0-22644437544
local.identifier.uidSubmittedByu4201517
local.type.statusPublished Version

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