Acute heart failure (AHF) classification and management are primarily based on lung congestion and/or hypoperfusion. The quantification of the vascular and tissue lung damage is not standard practice though biomarkers of lung injury may play a relevant role in this context. Haemodynamic stress promotes alveolar and vascular derangement with loss of functional units, impaired lung capillary permeability and fluid swelling. This culminates in a remodelling process with activation of inflammatory and cytokines pathways. Four families of lung surfactant proteins (i.e., SP-A, SP-B, SP-C, and SP-D), essential for the membrane biology and integrity are released by alveolar type II pneumocites. With deregulation of fluid handling and gas exchange pathways, SPs become sensitive markers of lung injury. We report the pathobiology of lung damage; the pathophysiological and clinical implications of alveolar SPs along with the newest evidence for some classical HF biomarkers that have also shown to reflect a vascular and/or a tissue lung-related activity.

Biomarkers of lung congestion and injury in acute heart failure / M. Guazzi, G. Novello, F. Bursi, A. Caretti, N. Furlotti, R. Arena, P. Argiento, J. Núñez, A. Bayes‐genis, M. Metra. - In: ESC HEART FAILURE. - ISSN 2055-5822. - (2024), pp. 1-9. [Epub ahead of print] [10.1002/ehf2.14982]

Biomarkers of lung congestion and injury in acute heart failure

M. Guazzi
Primo
;
F. Bursi;A. Caretti;N. Furlotti;
2024

Abstract

Acute heart failure (AHF) classification and management are primarily based on lung congestion and/or hypoperfusion. The quantification of the vascular and tissue lung damage is not standard practice though biomarkers of lung injury may play a relevant role in this context. Haemodynamic stress promotes alveolar and vascular derangement with loss of functional units, impaired lung capillary permeability and fluid swelling. This culminates in a remodelling process with activation of inflammatory and cytokines pathways. Four families of lung surfactant proteins (i.e., SP-A, SP-B, SP-C, and SP-D), essential for the membrane biology and integrity are released by alveolar type II pneumocites. With deregulation of fluid handling and gas exchange pathways, SPs become sensitive markers of lung injury. We report the pathobiology of lung damage; the pathophysiological and clinical implications of alveolar SPs along with the newest evidence for some classical HF biomarkers that have also shown to reflect a vascular and/or a tissue lung-related activity.
Acute heart failure; Alveolar-capillary unit; Lung biomarkers;
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
Settore MEDS-07/B - Malattie dell'apparato cardiovascolare
2024
8-ago-2024
Article (author)
File in questo prodotto:
File Dimensione Formato  
Biomarkers of lung congestion.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 979.25 kB
Formato Adobe PDF
979.25 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1087108
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 0
  • ???jsp.display-item.citation.isi??? 0
social impact