title: Surfactant-derived proteins as markers of alveolar membrane damage in heart failure.
abstract: BACKGROUND
  In heart failure (HF) alveolar-capillary membrane is abnormal. Surfactant-derived proteins (SPs) and plasma receptor for advanced-glycation-end-products (RAGE) have been proposed as lung damage markers.
  
  
  METHODS
  Eighty-nine chronic HF and 17 healthy subjects were evaluated by echocardiography, blood parameters, carbon monoxide lung diffusion (DLCO) and cardiopulmonary exercise test. We measured immature SP-B, mature SP-B, SP-A, SP-D and RAGE plasma levels.
  
  
  RESULTS
  Immature SP-B (arbitrary units), mature SP-A (ng/ml) and SP-D (ng/ml), but not mature SP-B (ng/ml) and RAGE (pg/ml) levels, were higher in HF than in controls [immature SP-B: 15.6 (13.1, 75th-25th interquartile range) Vs. 11.1 (6.4), p<0.01; SP-A, 29.6 (20.1) Vs. 18.3 (13.5), p = 0.01; SP-D: 125 (90) Vs. 78 (58), p<0.01]. Immature SP-B, SP-A, SP-D and RAGE values were related to DLCO, peak oxygen consumption, ventilatory efficiency, and brain natriuretic peptide (BNP), whereas plasma mature SP-B was not. The DLCO Vs. immature SP-B correlation was the strongest one. At multivariate analysis, RAGE was associated to age and creatinine, SP-A to DLCO and BNP, SP-D to BNP, mature SP-B to DLCO and creatinine, and immature SP-B only but strongly to DLCO.
  
  
  CONCLUSIONS
  Immature SP-B is the most reliable biological marker of alveolar-capillary membrane function in HF.
authors.affiliation: Institute of Diagnostic and Nuclear Development, Naples, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Gargiulo
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Banfi
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Ghilardi
authors.affiliation: Department of Clinical and Molecular Medicine, La Sapienza university, Rome, Italy.
authors.forename: Damiano
authors.initials: D
authors.lastname: Magrì
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Giovannardi
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Bonomi
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Salvioni
authors.affiliation: Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Battaia
authors.affiliation: Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
authors.forename: Pasquale Perrone
authors.initials: PP
authors.lastname: Filardi
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy; Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Tremoli
authors.affiliation: Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Agostoni
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002248:Carbon Monoxide / Q000378:metabolism; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000098:blood supply* / Q000473:pathology; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010101:Oxygen Consumption; D011650:Pulmonary Alveoli / Q000098:blood supply* / Q000473:pathology; D037662:Pulmonary Surfactant-Associated Protein A / Q000097:blood; D037701:Pulmonary Surfactant-Associated Protein B / Q000097:blood; D037663:Pulmonary Surfactant-Associated Protein D / Q000097:blood; D000067759:Receptor for Advanced Glycation End Products / Q000097:blood; D012129:Respiratory Function Tests
chemical_list: C000593871:AGER protein, human; D015415:Biomarkers; D037662:Pulmonary Surfactant-Associated Protein A; D037701:Pulmonary Surfactant-Associated Protein B; D037663:Pulmonary Surfactant-Associated Protein D; D000067759:Receptor for Advanced Glycation End Products; D020097:Natriuretic Peptide, Brain; D002248:Carbon Monoxide