Biomarkers of lung congestion and injury in acute heart failure

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 promo...

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Bibliographic Details
Authors: Guazzi, M., Novello, G., Bursi, F., Caretti, A., Furlotti, N., Arena, R., Argiento, P., Núñez, J., Bayés-Genís, Antoni|||0000-0002-3044-197X, Metra, M.
Format: article
Publication Date:2025
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:311681
Online Access:https://ddd.uab.cat/record/311681
https://dx.doi.org/urn:doi:10.1002/ehf2.14982
Access Level:Open access
Keyword:Acute heart failure
Alveolar-capillary unit
Lung biomarkers
Description
Summary: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.