Original Article

CA-125 Level Is Associated with Right Ventricular Echocardiographic Parameters in Patients with COPD

Authors: Omer Uz, MD, Ejder Kardesoglu, MD, Dilaver Tas, MD, Gurkan Acar, MD, Zafer Isilak, MD, Omer Yiginer, MD, Mustafa Aparci, MD, Bekir Yilmaz Cingozbay, MD, Bekir Sitki Cebeci, MD

Abstract

Objective: A few studies have shown that elevated CA-125 levels are associated with chronic obstructive pulmonary disease (COPD). However, there are no data concerning the associaton between serum CA-125 levels and right ventricular (RV) function in COPD patients. This study aimed to evaluate the relationship between CA-125 level and RV echocardiographic parameters in COPD patients.


Methods: Fifty-two patients with COPD (39 male/13 female, mean age 68.9 ± 5.7 years) were studied. The control group consisted of 30 age-sex matched healthy volunteers (23 male/7 female, mean age 64.2 ± 6.3 years). Patients were divided into two subgroups: patients without pulmonary hypertension (group I, n = 25) and with pulmonary hypertension (group II, n = 27). Conventional echocardiographic parameters, tissue Doppler imaging (TDI) and CA-125 level measurements were performed in all subjects.


Results: Patients in group II had significantly higher CA-125 levels than those in group I and controls (P < 0.01). CA-125 levels in group I were also higher than control group (P < 0.05). CA-125 levels were correlated with left ventricle E/A ratio, systolic pulmonary artery pressure (sPAP), RV myocardial performance index, and RV fractional area change (r = 0.37, 0.56, 0.34, and - 0.42, respectively, all with P < 0.05). There was an independent correlation between CA-125 levels and sPAP values (β = 0.76, P < 0.001)


Conclusions: Our results show an independent correlation between CA-125 levels and systolic pulmonary artery pressure in COPD patients. The clinical utility of these results at this point in time is unknown and deserves future research.

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References

1. Leuchte HH, Baumgartner RA, Nounou ME, et al. Brain natriuretic peptide is a prognostic parameter in chronic lung disease. Am J Respir Crit Care Med 2006;173:744-750.
 
2. Nuñez GR, Ito C, Del Giglio A. Increased serum CA-125 levels in patients with lung cancer post thoracotomy. South Med J 2009;102:427-428.
 
3. D'Aloia A, Faggiano P, Aurigemma G, et al. Serum levels of carbohydrate antigen 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;41:1805-1811.
 
4. Kouris NT, Zacharos ID, Kontogianni DD, et al. The significance of CA125 levels in patients with chronic congestive heart failure. Correlation with clinical and echocardiographic. parameters. Eur J Heart Fail 2005;7:199-203.
 
5. Vizzardi E, Nodari S, D'Aloia A, et al. CA 125 tumoral marker plasma levels relate to. systolic and diastolic ventricular function and to the clinical status of patients with chronic heart failure.Echocardiography 2008;25:955-960.
 
6. Duman C, Ercan E, Tengiz I, et al. Elevated serum CA 125 levels in mitral stenotic patients with heart failure. Cardiology 2003;100:7-10.
 
7. Yilmaz MB, Zorlu A, Tandogan I. Plasma CA-125 level is related to both sides of the heart: a retrospective analysis [published online ahead of print December 18, 2009]. Int J Cardiol 2009.
 
8. Bulut I, Arbak P, Coskun A, et al. Comparison of serum CA 19.9, CA 125 and CEA levels with severity of chronic obstructive pulmonary disease. Med Princ Pract 2009;18:289-293.
 
9. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma [this official statement of the American Thoracic Society was adopted by the ATS Board of Directors, November 1986]. Am Rev Respir Dis 1987;136:225-244.
 
10. Schiller NB, Shah PM, Crawford M, et al. Recommendations for quantitation of the left. ventricle by two-dimensional echocardiography: American Society of Echocardiography. Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiog 1989;2:358-367.
 
11. Kircher BJ, Himelman RB, Schiller NB. Noninvasive estimation of right atrial pressure from the inspiratory collapse of the inferior vena cava. Am J Cardiol 1990;66:493-496.
 
12. Murphy JG, Lloyd MA, McGoon MD. Pulmonary hypertension. In: Mayo Clinic Cardiology Review. 2nd ed. New York, Mayo Clinic Scientific Press; 2001:353.
 
13. Kidawa M, Kasprzak JD, Wierzchowski T, et al. Right ventricular function suffers from. reperfusion delay: tissue Doppler study. Clin Cardiol 2010;33:43-48.
 
14. Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010;23:685-713; quiz 786-788.
 
15. Varol E, Ozaydin M, Altinbas A, et al. Elevated carbohydrate antigen 125 levels in hypertrophic cardiomyopathy patients with heart failure. Heart Vessels 2007;22:30-33.
 
16. Sjövall K, Nilsson B, Einhorn N. The significance of serum CA 125 elevation in malignant and nonmalignant diseases. Gynecol Oncol 2002;85:175-178.
 
17. Sevinc A, Buyukberber S, Sari R, et al. Elevated serum CA-125 levels in patients with nephrotic syndrome-induced ascites. Anticancer Res 2000;20:1201-1203.
 
18. Sevinc A, Buyukberber S, Sari R. Elevated serum CA-125 levels: hepatitis or ascites? Gynecol Oncol 2000;76:141-142.
 
19. Sevinc A, Buyukberber S, Sari R, et al. Elevated serum CA-125 levels in hemodialysis. patients with peritoneal, pleural, or pericardial fluids. Gynecol Oncol 2000;77:254-257.
 
20. Mathew B, Bhatia V, Mahy IR, et al. Elevation of the tumor marker CA125 in right heart. failure. South Med J 2004;97:1013-1014.
 
21. Lockhart CJ, McVeigh GE, Harbinson MT. Elevated CA 125 and ascites: not always. malignancy. Ir J Med Sci 2008;177:63-66.
 
22. Tei C, Nishimura RA, Seward JB, et al. Noninvasive Doppler-derived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization. measurements. J Am Soc Echocardiogr 1997;10:169-178.
 
23. Ishii M, Eto G, Tei C, et al. Quantitation of the global right ventricular function in children with normal heart and congenital heart disease: a right ventricular myocardial performance index. Pediatr Cardiol 2000;21:416-421.
 
24. Tayyareci Y, Tayyareci G, Tastan CP, et al. Early diagnosis of right ventricular systolic dysfunction by tissue Doppler-derived isovolumic myocardial acceleration in patients with. chronic obstructive pulmonary disease. Echocardiography 2009;26:1026-1035.