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Assessing Invasive Hemodynamics in Pulmonary Hypertension: Examining the Predictive Utility of Carbohydrate Antigen 125 and N-terminal Pro-brain-type Natriuretic Peptide
Session:
Sessão de Posters 06 - Hipertensão Pulmonar
Speaker:
Nazar Ilchyshyn
Congress:
CPC 2024
Topic:
I. Hypertension
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.7 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure - Other
Session Type:
Cartazes
FP Number:
---
Authors:
Nazar Ilchyshyn; Joana de Sousa Varela; Ana Catarina Gomes; Filipa Ferreira; Sofia Alegria; Otília Simões; Bárbara Ferreira; Mariana Martinho; Diogo Cunha; Oliveira Baltazar; Liliana Brochado; Hélder Pereira
Abstract
<p style="text-align:justify"><strong>Introduction: </strong>N-terminal pro-brain-type natriuretic peptide (NT-proBNP) shows a correlation with the severity of pulmonary hypertension (PH). While elevated levels of the novel biomarker carbohydrate antigen 125 (Ca-125) have been associated with fluid congestion in heart failure (HF), its role in the context of PH remains unexplored.</p> <p style="text-align:justify"><strong>Purpose:</strong> Our goal was to examine whether Ca-125 and NT-proBNP could serve as reliable indicators predicting invasive hemodynamics in patients with PH and its role in clinical practice, particularly related to hemodynamic changes related to fluid congestion and disease progression.</p> <p style="text-align:justify"><strong>Methods:</strong> Prospective examination involving 19 patients with PH who underwent right heart catheterization between April and November 2023. We evaluated serum levels of Ca-125 and NT-proBNP. Elevated Ca-125 levels were defined as >30 U/mL and NT-proBNP levels as >1100 pg/mL. Demographic and procedural data were systematically reviewed. We investigated the association between CA-125 and NTproBNP with hemodynamic parameters and their predictive accuracy</p> <p style="text-align:justify"><strong>Results:</strong> The study population had a mean age of 63.5 ± 12.3 years, 73.7% being female, 31.6% classified as obese, and 31.6% having chronic renal disease (CKD). Among the PH groups, 42.1% were classified as group I, 31.6% as group II, and the remainder as group IV. No statistically significant differences were observed in age, gender, PH group, CKD, and HF history between patients with elevated versus lower levels of Ca-125 and NT-proBNP.</p> <p style="text-align:justify">In terms of hemodynamic parameters, significant differences were noted in mixed venous oxygen saturation (SvO2) between patients with elevated vs low levels of Ca-125 (70.6 ± 7.9 vs. 58.6 ± 6.1%, p=0.027) and NT-proBNP (71.8 ± 7.7 vs. 62.1 ± 7.7%, p=0.024). Pulmonary capillary wedge pressure (PCWP) differed significantly concerning NT-proBNP (12.6 ± 5.0 vs. 19.1 ± 8.1 mmHg, p=0.05). Other parameters, including right atrial pressure (RAP), mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance (PVR), and cardiac index (CI), did not exhibit significant differences.</p> <p style="text-align:justify">Ca-125 demonstrated a moderate and positive correlation with interleukin-6 (r=0.664, p=0.010) and NT-proBNP levels (r=0.504, p=0.028). In contrast, NT-proBNP exhibited a moderate positive correlation with serum creatinine (r=0.725, p<0.001) and a moderate negative correlation with SvO2 (r=-0.653, p=0.003).</p> <p style="text-align:justify">Notably, elevated Ca-125 accurately predicted elevated NT-proBNP levels (AUC 0.9, p=0.016), while elevated NT-proBNP accurately predicted PCWP (AUC 0.9, p=0.024) and RAP (AUC 0.85, p=0.048).</p> <p style="text-align:justify"><strong>Conclusions: </strong>In summary, our study indicates that elevated Ca-125 and NT-proBNP levels may signal invasive hemodynamic changes in pulmonary hypertension. Their interrelation suggests potential as complementary indicators of disease severity, warranting further validation in larger cohorts.</p>
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