Role of CA‐125 in Identification of Right Ventricular Failure in Chronic Obstructive Pulmonary Disease

Yilmaz, Mehmet Birhan; Zorlu, Ali; Doǧan, Ömer Tamer; Karahan, Oğuz; Tandoğan, İzzet; Akkurt, İbrahim

doi:10.1002/clc.20868

Cited by 30 publications

(19 citation statements)

References 69 publications

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“…D' Aloia et al [4] showed a significant correlation of CA 125 levels with the right atrial and systolic pulmonary artery pressure. In a different study by Yilmaz et al [5], elevated levels of CA 125 reflected right ventricle dysfunction in patients with COPD even before corpulmonale to be evident [5]. Our report adds to the literature a unique case that describe CA 125 elevation in a patient with isolated right heart failure in the setting of rheumatic heart disease [6,7].…”

Section: Discussionsupporting

confidence: 52%

Elevated Carbohydrate Antigen 125 Level in a Patient with Right Heart Failure

2015

JCCR

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A 55-year-old woman with history of rheumatic heart disease, mitral valve and aortic valve replacement four months ago was admitted with dyspnea, abdominal distention and swelling in her lower extremities. Her physical examination was remarkable for ascites and bilateral pedal edema. A chest roentogram showed a small right pleural effusion. Her electrocardiogram was consistent with sinus bradycardia. Her echocardiogram showed a normal left ventricular function with an ejection fraction of 55-60%, moderate pulmonary hypertension, moderately dilated right ventricle with moderately decreased function, moderate tricuspid regurgitation, moderate to severe pulmonic regurgitation, moderate right atrial enlargement and mild left atrial enlargement. Her right heart catheterization showed a right atrial pressure of 28 mmHg, a right ventricular end diastolic pressure of 31 mmHg, a pulmonary artery pressure of 92/36 mmHg, a mean pulmonary artery pressure of 68 mmHg, pulmonary capillary wedge pressure of 22 mmHg, a pulmonary artery saturation of 33% and a cardiac index of 1.7 L/min/m 2 . During initial investigation, it was found that her carbohydrate antigen (CA) 125 was markedly elevated to 871 U/ml (upper normal level is 35 U/ml). Investigation for gynecological malignancy by ultrasonography and computer tomography of the abdomen and pelvis was negative. Her ascites was tapped and the analysis did not show any malignant cells. She was started on diuretics and ionotropes with clinical improvement. Her symptoms were resolved and there was no evidence of abdominal distention on exam after few days of hospitalization. Since no obvious malignancy could be identified, her CA 125 was repeated and it was 35 U/ml. DiscussionThe CA 125 is a high molecular weight (approximately 2-5 million daltons) glycoprotein synthesized by epithelial serosal cells, such as the pleura, pericardium and peritoneum [1]. Inflammation or stretch of the serosal surface may be responsible for elevation of CA 125. The biological role of CA 125 in humans is not clearly understood. CA 125 is a tumor marker that is used in ovarian cancer. It has been shown to be useful for diagnosis of suspected cases, to monitor the efficacy of treatment and for early detection of recurrence. Increased CA 125 has also been noted in other neoplastic diseases like lung, breast, uterine and gastrointestinal tract cancer and non-neoplastic diseases like liver cirrhosis, serosal effusion and renal impairment [1]. Nagele et al. [2], while measuring various biomarkers in HF patients, were the first to identify this strong correlation between elevated CA 125 level and the severity of the clinical picture of patients [2]. Other studies investigated the evidence of this correlation in acute failure cases and right-sided failure cases [3,4]. D' Aloia et al. [4] showed a significant correlation of CA 125 levels with the right atrial and systolic pulmonary artery pressure. In a different study by Yilmaz et al. [5], elevated levels of CA 125 reflected right ventricle dysfunction in patie...

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Section: Discussionsupporting

confidence: 52%

Elevated Carbohydrate Antigen 125 Level in a Patient with Right Heart Failure

2015

JCCR

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“…MUC16 has been mostly studied in ovarian cancer, but is known to be expressed in normal airway epithelia and submucosal glands (Davies et al, 2007). The blood level of MUC16 in COPD patients was significantly higher than that in control subjects, and directly correlated with systolic pulmonary arterial pressure (Yilmaz et al, 2011). Other than these limited reports, the function of MUC16 in the airways is unknown.…”

Section: Mucus Mucins and Copdmentioning

confidence: 99%

Cellular and Molecular Biology of Airway Mucins

Lillehoj

Kato

et al. 2013

International Review of Cell and Molecular Biology

159

129

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Airway mucus constitutes a thin layer of airway surface liquid with component macromolecules that covers the luminal surface of the respiratory tract. The major function of mucus is to protect the lungs through mucociliary clearance of inhaled foreign particles and noxious chemicals. Mucus is comprised of water, ions, mucin glycoproteins, and a variety of other macromolecules, some of which possess anti-microbial, anti-protease, and anti-oxidant activities. Mucins comprise the major protein component of mucus and exist as secreted and cell-associated glycoproteins. Secreted, gel-forming mucins are mainly responsible for the viscoelastic property of mucus, which is crucial for effective mucociliary clearance. Cell-associated mucins shield the epithelial surface from pathogens through their extracellular domains and regulate intracellular signaling through their cytoplasmic regions. However, neither the exact structures of mucin glycoproteins, nor the manner through which their expression is regulated, are completely understood. This chapter reviews what is currently known about the cellular and molecular properties of airway mucins.

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“…Moreover, CA125 levels have been shown to correlate with adverse outcomes in patients with heart failure [14,15]. Recently carried out studies have also reported elevated CA125 levels in patients with coronary heart disease, chronic obstructive pulmonary disease, hypertrophic cardiomyopathy, cardiac angiosarcoma, infective perimyocarditis, and atrial fibrillation [5][6][7][8][9]. However, in stark contrast, few data have been published on the association between serum CA125 levels and the clinical outcomes of patients who have undergone OPCAB.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, normal cells from different tissues derived from coelomic epithelium, including the pericardium, pleura, and peritoneum, can produce CA125 in response to mechanical stress and inflammatory stimuli [2][3][4]. Recent studies have shown that increased CA125 levels play a prognostic role in cardiopulmonary disorders such as coronary heart disease, chronic obstructive pulmonary disease, hypertrophic cardiomyopathy, cardiac angiosarcoma, infective perimyocarditis, and atrial fibrillation [5][6][7][8][9]. However, the relationship between elevated CA125 levels and clinical outcomes after off-pump coronary artery bypass grafting (OPCAB) has not been reported.…”

Section: Introductionmentioning

confidence: 99%