Dixon DL, Bersten AD, Lawrence MD, Bihari S, Crouch G, De Pasquale CG
Int J Cardiol. 2016;207:213-214. doi:10.1016/j.ijcard.2016.01.134
The effects of acute and chronic heart failure on pulmonary function are complex. In acute cardiogenic pulmonary oedema, lung elastance is increased, parallel to acute alveolar flooding and associated surfactant dysfunction. However, in compensated CHF lung elastance has been variably reported as normal, or increased, likely reflecting a complex interplay between pulmonary remodelling and surfactant function. Surface tension normally comprises 60–70% of elastic recoil and is largely determined by surfactant function which is influenced by both phospholipid and surfactant protein (e.g. SP-B) content and function. Surfactant phospholipid can be separated into large surface-active aggregates (LA) and less surface-active, small aggregates (SA).