碳水化合物抗原-125 (CA125)：保留射血分数的心力衰竭患者右心室功能障碍和预后不良的标志

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-08-21 DOI:10.1016/j.ijcha.2025.101775

Sher May Ng , Geert H.D. Voordes , Michelle Lobeek , Michiel Rienstra , Adriaan A. Voors , Elke S. Hoendermis , Dirk J. van Veldhuisen , Thomas M. Gorter

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引用次数: 0

摘要

心衰（HF）伴射血分数（HFpEF）的右心室功能障碍（RVD）被发现较晚，且与不良预后相关。我们的目的是确定与HFpEF中RV功能障碍相关的生物标志物，并评估其预后意义。方法从一项前瞻性多中心研究中纳入77例HFpEF患者。在基线时，患者接受超声心动图、心脏磁共振（CMR）成像和实验室检查。对他们进行了全因死亡率和心衰住院率的综合结局参数随访。RVD定义为CMR时右心室射血分数(RVEF)≤45%。使用Olink蛋白质组学多重面板（CVDII， CVDIII，炎症和免疫肿瘤学）进行蛋白质组学分析，并对免疫分析进行进一步验证。结果HFpEF 19例（25%）有RVD。Olink蛋白组学分析发现，HFpEF和RVD患者血浆中碳水化合物抗原125 （CA125）的含量差异最大，与非RVD患者相比，进一步的免疫分析证实了这一点——RVD患者的中位CA125为23 kU/L[21-47]，而非RVD患者的中位CA125为16 [[12]，[13],[14],[15],[16],[17],[18],[19],[20]]（p < 0.001）。经年龄、性别、体重指数、LVEF、RVD、心房纤颤、肾功能和NTproBNP校正后，对数正常化CA125 （LnCA125）与较差的RVEF相关（r = - 0.29, p = 0.03），并预测较差的临床结果[全因死亡率和HF住院综合结果HR 2.28(1.28-4.07)]。结论靶向蛋白组学分析显示CA125是HFpEF人群RVD的生物标志物。较高的血清CA125浓度，而非NTproBNP，与全因死亡率和HF住院风险增加相关。字数：249。

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Carbohydrate antigen-125 (CA125): a marker of right ventricular dysfunction and poor prognosis in heart failure with preserved ejection fraction

Background

Right ventricular (RV) dysfunction (RVD) in heart failure (HF) with preserved ejection fraction (HFpEF) is recognised late and associated with poor outcomes. We aimed to identify biomarkers associated with RV dysfunction in HFpEF and evaluate their prognostic significance.

Methods

77 patients with HFpEF were enrolled from a prospective, multicentre study. At baseline, patients underwent echocardiography, cardiac magnetic resonance (CMR) imaging and laboratory testing. They were followed up for the composite outcome parameter of all-cause mortality and HF hospitalisation. RVD was defined as RV ejection fraction (RVEF) < 45 % on CMR. Proteomics analysis was performed using Olink proteomics multiplex panels (CVDII, CVDIII, Inflammatory and Immuno-oncology) with further verification on immunoassay analysis.

Results

19 patients with HFpEF (25 %) had RVD. The Olink proteomic analysis identified carbohydrate antigen 125 (CA125) as the most differentially abundant in plasma of patients with HFpEF and RVD as compared to those without RVD, which corroborated with further immunoassay analysis − median CA125 in patients with RVD was 23 kU/L [21–47] vs. 16 [[12], [13], [14], [15], [16], [17], [18], [19], [20]] in patients without RVD (p < 0.001). Log-normalised CA125 (LnCA125) was associated with worse RVEF (r = −0.29, p = 0.03) and predicted worse clinical outcomes [HR 2.28 (1.28–4.07) for the composite outcome of all-cause mortality and HF hospitalisation] adjusted for age, gender, body mass index, LVEF, RVD, atrial fibrillation, renal function and NTproBNP.

Conclusion

Targeted proteomic analysis reveals CA125 as a biomarker for RVD in a HFpEF population. Higher serum CA125 concentration, but not NTproBNP, was associated with an increased risk of all-cause mortality and HF hospitalisation.

Word Count: 249.

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.