Antonini-Canterin Francesco, Popescu Bogdan A, Popescu Andreea C, Beladan Carmen C, Korcova Renata, Piazza Rita, Cappelletti Piero, Rubin Daniela, Cassin Matteo, Faggiano Pompilio, Nicolosi Gian Luigi
Cardiologia, ARC, Azienda Ospedaliera S. Maria degli Angeli, Via Montereale, 24 33170 Pordenone, Italy.
Int J Cardiol. 2008 Aug 29;128(3):406-12. doi: 10.1016/j.ijcard.2007.05.039. Epub 2007 Jul 26.
Brain natriuretic peptide (BNP) is related to symptomatic status and outcome in aortic stenosis (AS) patients. Carbohydrate antigen 125 (CA125) demonstrated recently a BNP-like behaviour in patients with congestive heart failure (CHF) but has never been studied in AS patients. We aimed to assess the role of CA125 and BNP in AS patients.
CA125 and BNP blood levels, transthoracic echocardiography and independent evaluation of CHF symptoms were obtained in 64 consecutive patients (76+/-9 years; 35 males) with AS (valve area 0.9+/-0.3 cm(2)). A pre-specified combined end-point consisting of cardiac mortality, urgent aortic valve replacement and hospitalization for CHF was considered. The median follow-up was 8 months (interquartile range 4.5-10 months).
Both CA125 and BNP have accurately identified patients with III-IV NYHA class: area under the ROC curve was 0.85 for CA125 and 0.78 for BNP (best cut-offs of 10.3 U/mL and 254.64 pg/mL respectively) and were independently correlated to left ventricular ejection fraction. Fifty-two percent of patients with CA125>or=10.3 U/mL vs. 13% with CA125<10.3 U/mL (p<0.01) and 65% patients with BNP>or=254 pg/mL vs. 7% with BNP<254 pg/mL (p<0.001) have reached the end-point.
Both CA125 and BNP levels are significantly correlated with NYHA class and outcome in patients with AS. CA125 blood level assessment (less expensive) may improve the clinical management in this setting.
脑钠肽（BNP）与主动脉瓣狭窄（AS）患者的症状状态及预后相关。糖类抗原125（CA125）最近在充血性心力衰竭（CHF）患者中表现出类似BNP的特性，但从未在AS患者中进行过研究。我们旨在评估CA125和BNP在AS患者中的作用。
对64例连续的AS患者（年龄76±9岁；男性35例）（瓣膜面积0.9±0.3 cm²）测定CA125和BNP血水平、经胸超声心动图，并对CHF症状进行独立评估。考虑一个预先设定的综合终点，包括心脏性死亡、紧急主动脉瓣置换和因CHF住院。中位随访时间为8个月（四分位间距4.5 - 10个月）。
CA125和BNP均能准确识别纽约心脏协会（NYHA）心功能Ⅲ - Ⅳ级的患者：CA125的ROC曲线下面积为0.85，BNP为0.78（最佳截断值分别为10.3 U/mL和254.64 pg/mL），且均与左心室射血分数独立相关。CA125≥10.3 U/mL的患者中有52% vs. CA125＜10.3 U/mL的患者中有13%（p＜0.01），BNP≥254 pg/mL的患者中有65% vs. BNP＜254 pg/mL的患者中有7%（p＜0.001）达到了终点。
CA125和BNP水平均与AS患者的NYHA心功能分级及预后显著相关。CA125血水平评估（成本较低）可能会改善这种情况下的临床管理。
