title: 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.
abstract: OBJECTIVE
  The aim of this study was to evaluate the serum levels of carbohydrate antigen 125 (CA125) in patients with congestive heart failure (CHF).
  
  
  BACKGROUND
  CA125 is a glycoprotein produced by serosal epithelium, found to be increased in ovarian cancer.
  
  
  METHODS
  Serum levels of CA125 were obtained in 286 patients (122 males and 164 females; age 69 +/- 13 years) with CHF (left ventricular ejection fraction 30 +/- 11%). A non-invasive evaluation was obtained by Doppler echocardiography; right heart catheterization was performed in 88 patients. An attempt to adjust medical therapy to maximally tolerated doses was done, and CA125 was repeated after 18 days (range 7 to 40) in 80 patients. The mean follow-up duration was 6 +/- 3 months in 240 patients.
  
  
  RESULTS
  The mean value of CA125 was 68 +/- 83 U/ml (range 3 to 537): 71 +/- 85 in men and 56 +/- 64 U/ml in women (p = NS). CA125 above the normal value (<35 U/ml) was found in 152 (53%) of 286 patients; it was higher in patients with advanced New York Heart Association (NYHA) functional class (n = 140 in class I/II: 15 +/- 9 U/ml; n = 63 in class III: 57 +/- 18 U/ml; n = 83 in class IV: 167 +/- 94 U/ml; p < 0.005). CA125 was related to the deceleration time of early filling on transmitral Doppler (r = -0.63, p < 0.05) and to pulmonary artery wedge pressure (r = 0.66, p < 0.05) and right atrial pressure (r = 0.69, p < 0.05). During 6 +/- 3 months of follow-up, a combined end point of mortality and CHF hospitalization was observed in 16 of 127 patients with CA125 <35 U/ml, compared with 70 of 113 patients with CA125 >35 U/ml (p < 0.01). After medical treatment optimization, NYHA class decreased by more than one grade in 56 of 80 patients and was unchanged or increased in 24 patients: CA125 decreased from 125 +/- 98 to 53 +/- 61 U/ml (p < 0.001) in the former and changed from 130 +/- 81 to 153 +/- 61 U/ml (p = NS) in the latter.
  
  
  CONCLUSIONS
  Our data suggest that CA125 is related to CHF severity and short-term prognosis. Furthermore, fluctuations of CA125 serum levels over time may reflect changes induced by therapy. Therefore, measurements of CA 125 serum levels might be proposed for the serial assessment of CHF patients.
authors.affiliation: Cattedra di Cardiologia, Università di Brescia, Brescia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Aloia
authors.forename: Pompilio
authors.initials: P
authors.lastname: Faggiano
authors.forename: Gerard
authors.initials: G
authors.lastname: Aurigemma
authors.forename: Luca
authors.initials: L
authors.lastname: Bontempi
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Ruggeri
authors.forename: Marco
authors.initials: M
authors.lastname: Metra
authors.forename: Savina
authors.initials: S
authors.lastname: Nodari
authors.forename: Livio
authors.initials: L
authors.lastname: Dei Cas
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D006328:Cardiac Catheterization; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology; D006351:Heart Valves / Q000000981:diagnostic imaging / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D015996:Survival Rate; D018615:Ultrasonography, Doppler, Color; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D018394:CA-125 Antigen