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Predictive Value of Carbohydrate Antigen-125 in Determining the Left Ventricular Diastolic Dysfunction

Year 2022, Volume: 6 Issue: 1, 58 - 63, 27.03.2022
https://doi.org/10.30565/medalanya.972281

Abstract

Aim: Carbohydrate antigen-125 (CA-125) is a well-known marker for mesenchymal cell activation. It is being investigated as a predictive marker for cardiac pathologies due to pericardial or pleural mesenchymal cell activation. In this study, the relationship between left ventricular diastolic diameter (LVDd) and ejection fraction (EF) and serum CA-125 levels was investigated.

Method: Thirty-eight patients who underwent coronary artery bypass graft operation were included in the study. LVDd and EF values were calculated. Routine blood parameters and serum CA-125 levels were obtained from blood samples. Patients were divided into groups according to LVDd (LVDd <50mm vs. ≥50mm) and EF (EF <50% vs. EF≥50%).

Results: Among the low (<50%) and high (≥50%) EF groups, serum neutrophil, mean platelet volume (MPV), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), troponin-I, triglyceride, and very low density lipoprotein (VLDL) levels were statistically different (p<0.05). However, no statistical difference was observed between the low (<50mm) and high (≥50mm) LVDd groups in other blood parameters except for serum CA-125 levels (p>0.05). Higher serum CA-125 levels were obtained in patients with a high left ventricular diastolic diameter (≥50mm) (p<0.05). In addition, CA-125 was found to be an important predictor of left ventricular diastolic diameter with an optimal cut-off value of 0.644 kU/L (60% sensitivity and 78.3% specificity).

Conclusion: According to our results, increased serum CA-125 level is an independent predictor of higher LVDd and may be a good indicator of left ventricular functions.

References

  • 1. van der Bijl P, Abou R, Goedemans L, Gersh BJ, Holmes Jr DR, Marsan NA, et al. Left Ventricular Post-Infarct Remodeling: Implications for Systolic Function Improvement and Outcomes in the Modern Era. JACC Heart Fail. 2020;8(2):131-40. doi: 10.1016/j.jchf.2019.08.014.
  • 2. Faggiano P, D’Aloia A, Bignotti T, Dei Cas L. One biologic marker (carbohydrate antigen-CA 125), two different disease [ovarian cancer and congestive heart failure]: practical implications of monitoring CA 125 serum levels. A case report. Ital Heart J. 2003;4(7):497-9. PMID: 14558304
  • 3. Bottoni P, Scatena R. The Role of CA 125 as Tumor Marker: Biochemical and Clinical Aspects. Adv Exp Med Biol. 2015;867:229-44. doi: 10.1007/978-94-017-7215-0_14.
  • 4. Bischof P. What do we know about the origin of CA 125? Eur J Obstet Gynecol Reprod Biol. 1993;49(1-2):93-8. doi: 10.1016/0028-2243(93)90131-u.
  • 5. Faggiano P, D’Aloia A, Brentana L, Bignotti T, Fiorina C, Vizzardi E, et al. Serum levels of different tumour markers in patients with cronic heart failure. Eur J Heart Fail. 2005;7(1):57-61. doi: 10.1016/j.ejheart.2004.04.009.
  • 6. Kouris NT, Zacharos ID, Kontogianni DD, Goranitou GS, Sifaki MD, Grassos HE, et al. The significance of CA 125 levels in patients with chronic congestive heart failure. Correlation with clinical and achocardiographic parameters. Eur J Heart Fail. 2005;7(2):199-203. doi: 10.1016/j.ejheart.2004.07.015.
  • 7. Varol E, Ozaydin M, Dogan A, Kosar F. Tumour marker levels in patients with chronic heart failure. Eur J Heart Fail. 2005;7(5):840-3. doi: 10.1016/j.ejheart.2004.12.008.
  • 8. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14. doi: 10.1016/j.echo.2014.10.003.
  • 9. Yilmaz H, Gürel OM, Celik HT, Enes Sahiner E, Yildirim ME, Bilgiç MA, et al. CA 125 levels and left ventricular function in patients with end-stage renal disease on maintenance hemodialysis. Ren Fail. 2014;36(2):210-6. doi: 10.3109/0886022X.2013.859528.
  • 10. Moore RG, Miller MC, Steinhoff MM, Skates SJ, Lu KH, Lambert-Messerlian G, et al. Serum HE4 levels are less frequently elevated than CA 125 in women with benign gynecologic disorders. Am J Obstet Gynecol. 2012;206(4):351.e1-8. doi: 10.1016/j.ajog.2011.12.029.
  • 11. Buamah P. Benign conditions associated with raised serum CA 125 concentration. J Surg Oncol. 2000;75(4):264-5. doi: 10.1002/1096-9098(200012)75:4<264::aid-jso7>3.0.co;2-q.
  • 12. Hung CL, Hung TC, Lai YH, Lu CS, Wu YJ, Yeh HI. Beyond malignancy: the role of carbohydrate antigen 125 in heart failure. Biomark Res. 2013;1(1):25. doi: 10.1186/2050-7771-1-25.
  • 13. Nägele H, Bahlo M, Klapdor R, Rödiger W. Fluctuations of tumor markers in heart failure patients pre and post heart transplantation. Anticancer Res. 1999;19(4A):2531-4. PMID: 10470189.
  • 14. Duman D, Palit F, Simsek E, Bilgehan K. Serum carbohydrate antigen 125 levels in advanced heart failure: relation to B-type natriuretic peptide and left atrial volume. Eur J Heart Fail. 2008;10(6):556-9. doi: 10.1016/j.ejheart.2008.04.012.
  • 15. Turk HM, Pekdemir H, Buyukberber S, Sevinc A, Camci C, Kocabas R, et al. Serum CA 125 levels in patient with chronic heart failure and accompanying pleural fluid. Tumour Biol. 2003;24(4):172-5. doi: 10.1159/000074425.
  • 16. D'Aloia A, Faggiano P, Aurigemma G, Bontempi L, Ruggeri G, Metra M, et al .Serum levels of carbohydrate antigen 125 (CA 125) in patients with chronic heart failure: relation to clinical severity, hemodynamic and Doppler echocardiographic abnormalities and short term prognosis. J Am Coll Cardiol. 2003;41(10):1805-11. doi: 10.1016/s0735-1097(03)00311-5.
  • 17. Seo T, Ikeda Y, Onaka H, Hayashi T, Kawaguchi K, Kotake C, et al. Usefulness of serum CA 125 measurement for monitoring pericardial effusion. Jpn Circ J. 1993;57(6):489-94. doi: 10.1253/jcj.57.489.
  • 18. Battaloglu B, Kaya E, Erdil N, Nisanoglu V, Kosar F, Ozgur B, et al. Does cardiopulmonary bypass alter plasma level of tumor markers? CA 125 and carcinoembryonic antigen. Thorac Cardiovasc Surg . 2002;50(4):201-3. doi: 10.1055/s-2002-33102.
  • 19. Durak-Nalbantic A, Resic N , Kulic M, Pecar E , Zvizdic F, Dzubur A, et al. Serum level of tumor marker carbohydrate antigen-CA125 in heart failure. Med Arch. 2013;67(4):241-4. doi: 10.5455/medarh.2013.67.241-244.
  • 20. Vizzardi E , D'Aloia A, Pezzali N, Bugatti S, Curnis A, Dei Cas L. Long-term prognostic value of CA 125 serum levels in mild to moderate heart failure patients. J Card Fail. 2012;18(1):68-73. doi: 10.1016/j.cardfail.2011.09.012.
  • 21. Rong X, Yunke Z, Guoping L, Zhenyue C. Clinical and prognostic value of elevated CA125 levels in patients with coronary heart disease. Herz. 2015;40(4):690-4. doi: 10.1007/s00059-014-4109-y.
  • 22. Li J, Song SJ, Liu FL, Lou ZQ, Han Z, Wang Y, et al. Carbohydrate antigen 125 levels and clinical outcomes after off-pump coronary artery bypass grafting. Coron Artery Dis. 2015;26(5):432-6. doi: 10.1097/MCA.0000000000000262.
  • 23. Nambiar L, Li A, Howard A, LeWinter M, Meyer M. Left ventricular end-diastolic volume predicts exercise capacity in patients with a normal ejection fraction. Clin Cardiol. 2018;41(5):628-33. doi: 10.1002/clc.22928.
  • 24. Kajimoto K, Minami Y, Otsubo S, Sato N, Sex Differences in Left Ventricular Cavity Dilation and Outcomes in Acute Heart Failure Patients with Left Ventricular Systolic Dysfunction. Can J Cardiol. 2018;34(4):477-84. doi: 10.1016/j.cjca.2018.01.019.

Sol Ventrikül Diyastolik Disfonksiyonunun Belirlenmesinde Karbonhidrat Antijeni-125'in Tahmini Değeri

Year 2022, Volume: 6 Issue: 1, 58 - 63, 27.03.2022
https://doi.org/10.30565/medalanya.972281

Abstract

Amaç: Karbonhidrat antijeni-125 (CA-125), mezenkimal hücre aktivasyonu için iyi bilinen bir belirteçtir. Perikardiyal veya plevral mezenkimal hücre aktivasyonuna bağlı kardiyak patolojiler için öngörücü bir belirteç olarak araştırılmaktadır. Bu çalışmada sol ventrikül diyastolik çapı (LVDd) ve ejeksiyon fraksiyonu (EF) ile serum CA-125 seviyeleri arasındaki ilişki araştırıldı.

Yöntem: Koroner arter baypas greft operasyonu uygulanan 38 hasta çalışmaya dahil edildi. LVDd ve EF değerleri hesaplandı. Kan örneklerinden rutin kan parametreleri ve serum CA-125 seviyeleri elde edildi. Hastalar LVDd (LVDd <50mm vs. ≥50mm) ve EF'ye (EF <%50 vs. EF≥%50) göre gruplara ayrıldı.

Bulgular: Düşük (<%50) ve yüksek (≥ %50) EF grupları arasında serum nötrofil, ortalama trombosit hacmi (MPV), laktat dehidrogenaz (LDH), aspartat aminotransferaz (AST), troponin-I, trigliserit ve çok düşük yoğunluklu lipoprotein (VLDL) düzeyleri istatistiksel olarak farklıydı (p<0.05). Ancak düşük (<50mm) ve yüksek (≥50mm) LVDd grupları arasında serum CA-125 düzeyleri dışında diğer kan parametrelerinde istatistiksel fark gözlenmedi (p>0.05). Sol ventrikül diyastolik çapı yüksek (≥50mm) olan hastalarda serumda daha yüksek CA-125 seviyeleri elde edildi (p<0.05). Ayrıca, CA-125, 0,644 kU‎/L'lik optimal cut-off değeri (%60 duyarlılık ve %78,3 özgüllük) ile sol ventrikül diyastolik çapının belirlenmesinde önemli bir öngörücü belirteç olarak bulundu.

Sonuç: Sonuçlarımıza göre artmış serum CA-125 düzeyinin daha yüksek LVDd için bağımsız bir öngörücü olduğu ve sol ventrikül fonksiyonlarının iyi bir göstergesi olabileceği görülmektedir.

References

  • 1. van der Bijl P, Abou R, Goedemans L, Gersh BJ, Holmes Jr DR, Marsan NA, et al. Left Ventricular Post-Infarct Remodeling: Implications for Systolic Function Improvement and Outcomes in the Modern Era. JACC Heart Fail. 2020;8(2):131-40. doi: 10.1016/j.jchf.2019.08.014.
  • 2. Faggiano P, D’Aloia A, Bignotti T, Dei Cas L. One biologic marker (carbohydrate antigen-CA 125), two different disease [ovarian cancer and congestive heart failure]: practical implications of monitoring CA 125 serum levels. A case report. Ital Heart J. 2003;4(7):497-9. PMID: 14558304
  • 3. Bottoni P, Scatena R. The Role of CA 125 as Tumor Marker: Biochemical and Clinical Aspects. Adv Exp Med Biol. 2015;867:229-44. doi: 10.1007/978-94-017-7215-0_14.
  • 4. Bischof P. What do we know about the origin of CA 125? Eur J Obstet Gynecol Reprod Biol. 1993;49(1-2):93-8. doi: 10.1016/0028-2243(93)90131-u.
  • 5. Faggiano P, D’Aloia A, Brentana L, Bignotti T, Fiorina C, Vizzardi E, et al. Serum levels of different tumour markers in patients with cronic heart failure. Eur J Heart Fail. 2005;7(1):57-61. doi: 10.1016/j.ejheart.2004.04.009.
  • 6. Kouris NT, Zacharos ID, Kontogianni DD, Goranitou GS, Sifaki MD, Grassos HE, et al. The significance of CA 125 levels in patients with chronic congestive heart failure. Correlation with clinical and achocardiographic parameters. Eur J Heart Fail. 2005;7(2):199-203. doi: 10.1016/j.ejheart.2004.07.015.
  • 7. Varol E, Ozaydin M, Dogan A, Kosar F. Tumour marker levels in patients with chronic heart failure. Eur J Heart Fail. 2005;7(5):840-3. doi: 10.1016/j.ejheart.2004.12.008.
  • 8. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14. doi: 10.1016/j.echo.2014.10.003.
  • 9. Yilmaz H, Gürel OM, Celik HT, Enes Sahiner E, Yildirim ME, Bilgiç MA, et al. CA 125 levels and left ventricular function in patients with end-stage renal disease on maintenance hemodialysis. Ren Fail. 2014;36(2):210-6. doi: 10.3109/0886022X.2013.859528.
  • 10. Moore RG, Miller MC, Steinhoff MM, Skates SJ, Lu KH, Lambert-Messerlian G, et al. Serum HE4 levels are less frequently elevated than CA 125 in women with benign gynecologic disorders. Am J Obstet Gynecol. 2012;206(4):351.e1-8. doi: 10.1016/j.ajog.2011.12.029.
  • 11. Buamah P. Benign conditions associated with raised serum CA 125 concentration. J Surg Oncol. 2000;75(4):264-5. doi: 10.1002/1096-9098(200012)75:4<264::aid-jso7>3.0.co;2-q.
  • 12. Hung CL, Hung TC, Lai YH, Lu CS, Wu YJ, Yeh HI. Beyond malignancy: the role of carbohydrate antigen 125 in heart failure. Biomark Res. 2013;1(1):25. doi: 10.1186/2050-7771-1-25.
  • 13. Nägele H, Bahlo M, Klapdor R, Rödiger W. Fluctuations of tumor markers in heart failure patients pre and post heart transplantation. Anticancer Res. 1999;19(4A):2531-4. PMID: 10470189.
  • 14. Duman D, Palit F, Simsek E, Bilgehan K. Serum carbohydrate antigen 125 levels in advanced heart failure: relation to B-type natriuretic peptide and left atrial volume. Eur J Heart Fail. 2008;10(6):556-9. doi: 10.1016/j.ejheart.2008.04.012.
  • 15. Turk HM, Pekdemir H, Buyukberber S, Sevinc A, Camci C, Kocabas R, et al. Serum CA 125 levels in patient with chronic heart failure and accompanying pleural fluid. Tumour Biol. 2003;24(4):172-5. doi: 10.1159/000074425.
  • 16. D'Aloia A, Faggiano P, Aurigemma G, Bontempi L, Ruggeri G, Metra M, et al .Serum levels of carbohydrate antigen 125 (CA 125) in patients with chronic heart failure: relation to clinical severity, hemodynamic and Doppler echocardiographic abnormalities and short term prognosis. J Am Coll Cardiol. 2003;41(10):1805-11. doi: 10.1016/s0735-1097(03)00311-5.
  • 17. Seo T, Ikeda Y, Onaka H, Hayashi T, Kawaguchi K, Kotake C, et al. Usefulness of serum CA 125 measurement for monitoring pericardial effusion. Jpn Circ J. 1993;57(6):489-94. doi: 10.1253/jcj.57.489.
  • 18. Battaloglu B, Kaya E, Erdil N, Nisanoglu V, Kosar F, Ozgur B, et al. Does cardiopulmonary bypass alter plasma level of tumor markers? CA 125 and carcinoembryonic antigen. Thorac Cardiovasc Surg . 2002;50(4):201-3. doi: 10.1055/s-2002-33102.
  • 19. Durak-Nalbantic A, Resic N , Kulic M, Pecar E , Zvizdic F, Dzubur A, et al. Serum level of tumor marker carbohydrate antigen-CA125 in heart failure. Med Arch. 2013;67(4):241-4. doi: 10.5455/medarh.2013.67.241-244.
  • 20. Vizzardi E , D'Aloia A, Pezzali N, Bugatti S, Curnis A, Dei Cas L. Long-term prognostic value of CA 125 serum levels in mild to moderate heart failure patients. J Card Fail. 2012;18(1):68-73. doi: 10.1016/j.cardfail.2011.09.012.
  • 21. Rong X, Yunke Z, Guoping L, Zhenyue C. Clinical and prognostic value of elevated CA125 levels in patients with coronary heart disease. Herz. 2015;40(4):690-4. doi: 10.1007/s00059-014-4109-y.
  • 22. Li J, Song SJ, Liu FL, Lou ZQ, Han Z, Wang Y, et al. Carbohydrate antigen 125 levels and clinical outcomes after off-pump coronary artery bypass grafting. Coron Artery Dis. 2015;26(5):432-6. doi: 10.1097/MCA.0000000000000262.
  • 23. Nambiar L, Li A, Howard A, LeWinter M, Meyer M. Left ventricular end-diastolic volume predicts exercise capacity in patients with a normal ejection fraction. Clin Cardiol. 2018;41(5):628-33. doi: 10.1002/clc.22928.
  • 24. Kajimoto K, Minami Y, Otsubo S, Sato N, Sex Differences in Left Ventricular Cavity Dilation and Outcomes in Acute Heart Failure Patients with Left Ventricular Systolic Dysfunction. Can J Cardiol. 2018;34(4):477-84. doi: 10.1016/j.cjca.2018.01.019.
There are 24 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Research Article
Authors

Nazım Kankılıç 0000-0001-7111-7503

Publication Date March 27, 2022
Submission Date July 16, 2021
Acceptance Date November 21, 2021
Published in Issue Year 2022 Volume: 6 Issue: 1

Cite

Vancouver Kankılıç N. Predictive Value of Carbohydrate Antigen-125 in Determining the Left Ventricular Diastolic Dysfunction. Acta Med. Alanya. 2022;6(1):58-63.

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