Serum Carbohydrate Antigen 125 Levels in Advanced Heart Failure: Relation to B-Type Natriuretic Peptide and Left Atrial Volume

AIMS: To assess the relation between serum levels of carbohydrate antigen 125 (CA 125) and parameters of left ventricular (LV) filling pressure in patients with advanced heart failure (AHF). METHODS: Forty-nine patients (mean age 67+/-10 years) with LV ejection fraction (EF) < or =0.35 and New York Heart Association (NYHA) class III or IV symptoms of heart failure were enrolled. Left atrial volume indexed to body surface area (LAVI) and the ratio of mitral inflow early diastolic velocity to annulus velocity (E/e) were evaluated with pulsed wave and tissue Doppler. Plasma B-type natriuretic peptide (BNP) was also measured. RESULTS: The median overall CA 125 value was 44.0 (17.7-140) U/ml. CA 125 above the normal value (<35 U/ml) was found in 28 of the 49 patients (57%). Compared to patients with normal CA 125 levels, those with elevated CA 125 had a higher NYHA class and increased serum BNP levels, LAVI and E/e. In multivariate analysis, serum CA 125 levels were significantly associated with BNP (standardized beta coefficient=0.58, p<0.001) and LAVI (standardized beta coefficient 0.34, p<0.005). CONCLUSION: Our study demonstrates that elevated serum CA 125 levels are associated with increased LAVI in parallel to increased neurohormonal activation in patients with AHF.