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 pa...

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Main Authors: Sher May Ng, Geert H.D. Voordes, Michelle Lobeek, Michiel Rienstra, Adriaan A. Voors, Elke S. Hoendermis, Dirk J. van Veldhuisen, Thomas M. Gorter
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:International Journal of Cardiology: Heart & Vasculature
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352906725001782
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author Sher May Ng
Geert H.D. Voordes
Michelle Lobeek
Michiel Rienstra
Adriaan A. Voors
Elke S. Hoendermis
Dirk J. van Veldhuisen
Thomas M. Gorter
author_facet Sher May Ng
Geert H.D. Voordes
Michelle Lobeek
Michiel Rienstra
Adriaan A. Voors
Elke S. Hoendermis
Dirk J. van Veldhuisen
Thomas M. Gorter
author_sort Sher May Ng
collection DOAJ
description 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 [12–20] 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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spelling doaj-art-719d0fb9ea78470095d04f7f660902f42025-08-22T04:56:53ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672025-10-016010177510.1016/j.ijcha.2025.101775Carbohydrate antigen-125 (CA125): a marker of right ventricular dysfunction and poor prognosis in heart failure with preserved ejection fractionSher May Ng0Geert H.D. Voordes1Michelle Lobeek2Michiel Rienstra3Adriaan A. Voors4Elke S. Hoendermis5Dirk J. van Veldhuisen6Thomas M. Gorter7University of Groningen, University Medical Centre Groningen, Department of Cardiology, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the Netherlands; Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Level 0, John Radcliffe Hospital, Oxford OX3 9DU, United KingdomUniversity of Groningen, University Medical Centre Groningen, Department of Cardiology, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the NetherlandsUniversity of Groningen, University Medical Centre Groningen, Department of Cardiology, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the NetherlandsUniversity of Groningen, University Medical Centre Groningen, Department of Cardiology, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the NetherlandsUniversity of Groningen, University Medical Centre Groningen, Department of Cardiology, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the NetherlandsUniversity of Groningen, University Medical Centre Groningen, Department of Cardiology, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the NetherlandsUniversity of Groningen, University Medical Centre Groningen, Department of Cardiology, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the NetherlandsUniversity of Groningen, University Medical Centre Groningen, Department of Cardiology, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the Netherlands; Corresponding author at: Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands.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 [12–20] 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.http://www.sciencedirect.com/science/article/pii/S2352906725001782CA125Right ventricular dysfunctionHFpEF
spellingShingle Sher May Ng
Geert H.D. Voordes
Michelle Lobeek
Michiel Rienstra
Adriaan A. Voors
Elke S. Hoendermis
Dirk J. van Veldhuisen
Thomas M. Gorter
Carbohydrate antigen-125 (CA125): a marker of right ventricular dysfunction and poor prognosis in heart failure with preserved ejection fraction
International Journal of Cardiology: Heart & Vasculature
CA125
Right ventricular dysfunction
HFpEF
title Carbohydrate antigen-125 (CA125): a marker of right ventricular dysfunction and poor prognosis in heart failure with preserved ejection fraction
title_full Carbohydrate antigen-125 (CA125): a marker of right ventricular dysfunction and poor prognosis in heart failure with preserved ejection fraction
title_fullStr Carbohydrate antigen-125 (CA125): a marker of right ventricular dysfunction and poor prognosis in heart failure with preserved ejection fraction
title_full_unstemmed Carbohydrate antigen-125 (CA125): a marker of right ventricular dysfunction and poor prognosis in heart failure with preserved ejection fraction
title_short Carbohydrate antigen-125 (CA125): a marker of right ventricular dysfunction and poor prognosis in heart failure with preserved ejection fraction
title_sort carbohydrate antigen 125 ca125 a marker of right ventricular dysfunction and poor prognosis in heart failure with preserved ejection fraction
topic CA125
Right ventricular dysfunction
HFpEF
url http://www.sciencedirect.com/science/article/pii/S2352906725001782
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