Zhang Yi, Jin Qi, Zhao Zhihui, Zhao Qing, Yu Xue, Yan Lu, Li Xin, Duan Anqi, An Chenhong, Ma Xiuping, Xiong Changming, Luo Qin, Liu Zhihong
Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.
Front Cardiovasc Med. 2021 Jul 20;8:699904. doi: 10.3389/fcvm.2021.699904. eCollection 2021.
Emerging evidence has showed that serum carbohydrate antigen 125 (CA 125) levels are associated with the severity and prognosis of heart failure. However, its role in pulmonary hypertension remains unclear. This study aimed to investigate the clinical, echocardiographic, hemodynamic, and prognostic associations of CA 125 in pulmonary hypertension. We conducted a retrospective cohort study of all idiopathic pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension patients receiving CA 125 measurement in Fuwai Hospital (January 1, 2014-December 31, 2018). The primary end-point was cumulative 1-year clinical worsening-free survival rate. Linear regression was performed to assess the association between CA 125 and clinical, echocardiographic, and hemodynamic parameters. Cox proportional hazards models were used to assess the association between CA 125 and clinical worsening events. Receiver operating characteristic (ROC) curve analysis was performed to determine the predictive performance of CA 125. A total of 231 patients were included. After adjustment, CA 125 still positively correlated with World Health Organization functional class, NT-proBNP, right ventricular end-diastolic diameter, pericardial effusion, mean right atrial pressure and pulmonary arterial wedge pressure; negatively correlated with 6-min walk distance, left ventricular end-diastolic diameter, mixed venous oxygen saturation, and cardiac index. After adjustment, CA 125 > 35 U/ml was associated with over 2 folds increased risk of 1-year clinical worsening. Further, ROC analysis showed that CA 125 provided additional predictive value in addition to the established pulmonary hypertension biomarker NT-proBNP. CA 125 was associated with functional status, echocardiography, hemodynamics and prognosis of pulmonary hypertension.
新出现的证据表明，血清糖类抗原125（CA 125）水平与心力衰竭的严重程度和预后相关。然而，其在肺动脉高压中的作用仍不清楚。本研究旨在探讨CA 125在肺动脉高压中的临床、超声心动图、血流动力学及预后相关性。我们对2014年1月1日至2018年12月31日期间在阜外医院接受CA 125检测的所有特发性肺动脉高压和慢性血栓栓塞性肺动脉高压患者进行了一项回顾性队列研究。主要终点是1年累积无临床恶化生存率。采用线性回归评估CA 125与临床、超声心动图和血流动力学参数之间的关联。使用Cox比例风险模型评估CA 125与临床恶化事件之间的关联。进行受试者操作特征（ROC）曲线分析以确定CA 125的预测性能。共纳入231例患者。调整后，CA 125仍与世界卫生组织功能分级、N末端B型利钠肽原（NT-proBNP）、右心室舒张末期内径、心包积液、平均右心房压和肺动脉楔压呈正相关；与6分钟步行距离、左心室舒张末期内径、混合静脉血氧饱和度和心脏指数呈负相关。调整后，CA 125>35 U/ml与1年临床恶化风险增加2倍以上相关。此外，ROC分析表明，除了已有的肺动脉高压生物标志物NT-proBNP外，CA 125还具有额外的预测价值。CA 125与肺动脉高压的功能状态、超声心动图、血流动力学及预后相关。
