Lack of correlation between levels of surfactant B and NT-pro-NBP in acute heart failure: an admission to discharge study

Abstract Background Acute pulmonary edema (APE) is a main cause of hospitalization for heart failure (HF). Surfactant type B (Surf-B) is a sensitive biomarker of alveolar damage that has been partially studied in chronic HF unless acute HF. Aims To clarify the pattern of Surf-B changes compared to the gold standard NT-pro-BNP after decongestion therapy. Methods 36 patients with acute HF due to APE (average age 74,9 ± 8,94; LVEF 36,7 ± 12,6; 61,0% males) underwent a combined evaluation of Surf-B, NT-pro-BNP levels with quantification of B-lines at hospital admission (time 0) and discharge (time 1). Results At time 1, the average Surf-B and NT-pro-BNP and B- lines were significantly lower compared to time 0. Interestingly, no correlation between Surf B and NT-pro-BNP was observed either at time 0 and time 1. A correlation between B-lines and Surf-B was observed only at time 0 while the correlation between NT-pro-BNP and B lines was observed just at time 1 (Table). Despite the significant average changes in Surf-B from admission to discharge, 28% of cases behaved as non-responders exhibiting a lack of reduction in Surf-B compared to NT-pro-BNP at time 1. Conclusions These data suggest that an organ specific biomarker of lung organ damage such as Surf-B is sensitive to decongestion therapy at a different extent compared to NT-pro-BNP with the two biomarkers that do not correlate each other. The evidence of a 28% cases of Surf-B non-responder subjects suggests that reparative process of alveolar break damage may dissociate from hemodynamic and cardiac benefits in acute HF.Table