Plasma immature form of surfactant protein type B correlates with prognosis in patients with chronic heart failure. A pilot single-center prospective study

Damiano Magrì, Cristina Banfi, Antonello Maruotti, Stefania Farina, Carlo Vignati, Elisabetta Salvioni, Marco Morosin, Maura Brioschi, Stefania Ghilardi, Elena Tremoli, Piergiuseppe Agostoni

Research output: Contribution to journalArticle

Abstract

Background Gas exchange abnormalities are part of the heart failure (HF) syndrome and growing interest raised on possible biomarkers of alveolar-capillary unit damage. The present pilot single-center study sought to investigate the prognostic values of circulating surfactant protein type B (SP-B) in a cohort of systolic HF patients. Methods One hundred and fifty-one HF stable outpatients and 37 healthy subjects underwent a full clinical assessment, including pulmonary function and lung diffusion for carbon monoxide (DLco), maximal cardiopulmonary exercise test and measurements for both circulating immature and mature forms of SP-B. Study end-points were hospitalization due to HF worsening and cardiovascular mortality. Results Immature SP-B, but not the mature form, was significantly higher in HF patients than in controls and was independently related to DLco, peak oxygen uptake and ventilatory efficiency. During the follow-up (median: 995 days; interquartile range: 739-1247 days), 97 patients experimented at least one HF hospitalization and 9 died for cardiovascular causes. At univariate analysis immature SP-B levels were significantly related to both cardiovascular death (p = 0.033) and HF hospitalization (p <0.001). At multivariate analysis, immature SP-B levels remained independently associated to HF hospitalization (hazard ratio: 2.304; 95% confidence interval 1.858-3.019; p <0.001). Conclusions Present data confirm a strong relationship between circulating immature SP-B levels, gas exchange abnormalities and exercise limitations in stable HF as well as they are consistent with the use of immature SP-B in HF clinical risk assessment. Larger prospective studies are needed to confirm its prognostic role as well as to evaluate whether immature SP-B plasma concentration varies in response to specific treatment.

Original languageEnglish
Pages (from-to)394-399
Number of pages6
JournalInternational Journal of Cardiology
Volume201
DOIs
Publication statusPublished - Oct 10 2015

Keywords

  • Alveolar-capillary unit
  • Cardiopulmonary exercise test
  • Heart failure
  • Lung diffusion
  • Prognosis
  • Surfactant protein type B

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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