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

Carmine G. De Pasquale, Leonard F. Arnolda, Ian R. Doyle, Philip E. Aylward, Derek P. Chew, Andrew D. Bersten

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

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 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.

LanguageEnglish
Pages1091-1096
Number of pages6
JournalCirculation
Volume110
Issue number9
DOIs
Publication statusPublished - 31 Aug 2004

Keywords

  • Edema
  • Heart failure
  • Lung
  • Natriuretic peptides
  • Proteins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

De Pasquale, C. G., Arnolda, L. F., Doyle, I. R., Aylward, P. E., Chew, D. P., & Bersten, A. D. (2004). Plasma surfactant protein-B: A novel biomarker in chronic heart failure. Circulation, 110(9), 1091-1096. https://doi.org/10.1161/01.CIR.0000140260.73611.FA
De Pasquale, Carmine G. ; Arnolda, Leonard F. ; Doyle, Ian R. ; Aylward, Philip E. ; Chew, Derek P. ; Bersten, Andrew D. / Plasma surfactant protein-B : A novel biomarker in chronic heart failure. In: Circulation. 2004 ; Vol. 110, No. 9. pp. 1091-1096.
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abstract = "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 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.",
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De Pasquale, CG, Arnolda, LF, Doyle, IR, Aylward, PE, Chew, DP & Bersten, AD 2004, 'Plasma surfactant protein-B: A novel biomarker in chronic heart failure', Circulation, vol. 110, no. 9, pp. 1091-1096. https://doi.org/10.1161/01.CIR.0000140260.73611.FA

Plasma surfactant protein-B : A novel biomarker in chronic heart failure. / De Pasquale, Carmine G.; Arnolda, Leonard F.; Doyle, Ian R.; Aylward, Philip E.; Chew, Derek P.; Bersten, Andrew D.

In: Circulation, Vol. 110, No. 9, 31.08.2004, p. 1091-1096.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Plasma surfactant protein-B

T2 - Circulation

AU - De Pasquale, Carmine G.

AU - Arnolda, Leonard F.

AU - Doyle, Ian R.

AU - Aylward, Philip E.

AU - Chew, Derek P.

AU - Bersten, Andrew D.

PY - 2004/8/31

Y1 - 2004/8/31

N2 - 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 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.

AB - 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 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.

KW - Edema

KW - Heart failure

KW - Lung

KW - Natriuretic peptides

KW - Proteins

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De Pasquale CG, Arnolda LF, Doyle IR, Aylward PE, Chew DP, Bersten AD. Plasma surfactant protein-B: A novel biomarker in chronic heart failure. Circulation. 2004 Aug 31;110(9):1091-1096. https://doi.org/10.1161/01.CIR.0000140260.73611.FA