Comparative study of CA-125 and 2D echo for detection of right ventricular failure in COPD patients
Keywords:CA-125, COPD, Right heart failure
Background: COPD is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. It leads to cor pulmonale causing right ventricular failure. Present study compares the serum level of CA-125 and 2 D Echo for detection of right ventricular failure in COPD patients.
Methods: In this study 178 patients suffering from COPD has been taken after following inclusion and exclusion criteria and informed consent. Serum CA 125 levels are evaluated in all patients and compared with the right ventricular functions.
Results: The mean CA125 was higher in subjects with RV failure (96.32) as compared to those subjects with RV normal (37.17). The result was statistically significant. (p<0.001). The mean duration of illness was higher in subjects with raised CA125 (8.71 years) as compared to those with normal CA 125 (6.67 years) and the difference was also statistically significant (P<0.001).
Conclusions: CA-125 levels have a good sensitivity and specificity for predicting right ventricular failure in COPD patients. Diagnostic accuracy, high positive and negative predictive value makes CA-125 a good predictor of right ventricular failure in COPD patients.
World Health Organization. Burden of COPD. Available at: http:/ /www.who.int/ respiratory/copd/ burden/en/. (Last accessed on 2013 Jun 5).
Fisher MR, Forfia PR, Chamera E, Housten-Harris T, Champion HC, Girgis RE, et al. Accuracy of doppler echocardiography in the hemodynamic assessment of pulmonary hypertension. Am J Respiratory Critical Care Medicine. 2009;179(7):615-21
Yilmaz MB, Zorlu A, Tandogan I. Plasma CA-125 level is related to both sides of the heart: a retrospective analysis. Int J Cardiol. 2011;149(1):80-2.
Nägele H, Bahlo M, Klapdor R, Schaeperkoetter D, Rödiger W. CA 125 and its relation to cardiac function. Am Heart J. 1999;137(6):1044-9.
D’Aloia A, Faggiano P, Aurigemma G, Bontempi L, Ruggeri G, Metra M, 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(10):1805-11.
Nagele H, Bahlo M, Klapdor R, Schaeperkoetter D, Rodiger W. CA 12-5 and its Relation to cardiac function pre-and post-Heart transplantation. Anticancer Res. 1999;19(4):2531-4.
Benjamin Burrows, Louis J. Kettel, Albert H. Niden, Murray Rabinowitz, Carl F. Diener. Patterns of cardiovascular dysfunction in chronic obstructive lung disease. N Engl J Med. 1972; 286(17): 912-7.
Weitzenblum E, Hirth C, Ducolone A, Mirhom R, Rasaholinjanahary J, Ehrhart M. Prognostic value of pulmonary artery pressure in chronic obstructive pulmonary disease. Thorax. 1981;36(10):752-8.
Bulut I, Arbak P, Coskun A, Balbay O, Annakkaya AN, Yavuz O, et al. Comparison of serum CA 19.9, CA 125 and CEA levels with severity of chronic obstructive pulmonary disease. Med Princip Pract. 2009;18(4):289-93.
Ordu S, Ozhan H, Alemdar R, Aydin M, Caglar O, Yuksel H, Kandis H. Carbohydrate antigen-125 and N-terminal pro-brain natriuretic peptide levels: compared in heart-failure prognostication. Texas Heart Inst J. 2012;39(1):30.
Banergae JC. Natural history and symptomatology of chronic corpulmonlae. Indian J Chest Dis. 1965;8:174-81.
Chappel AG. The electrocardiogram in chronic bronchitis and emphysema. Br Heart J. 1966;28:517-22.