CA 125 and its relation to cardiac function

Background CA 125, known cls a marker for ovarian cancer with hypothetical but hitherto uncharacterized biologic functions, was reported to be elevate d in some not-well-defined benign conditions. There are no reports on fluct uations of CA 125 related to cardiac function, especially the failing heart and neurohumoral factors such as norepinephrine or atrial natriuretic pept id/e. Methods and Results cn 125 blood levels were determined in patients with he art failure before and after heart transplantation (HTx). In 71 patients, p arallel determinations of norepinephrine, atrial natriuretic peptide, pulmo nary capillary wedge pressure, and right atrial filling pressure were done. CA 125 levels also were prospectively studied in patients with heart failu re with stabilization (n = 25) or worsening of the clinical status (n = 9) and after HTx (n = 25), Parallel determinations of the tumor markers CEA, C A 199, CA 153, TPS, end TPA were also done. The results were grouped accord ing to the clinical status (New York Heart Association class) of the patien ts, CA 125 was significantly correlated with neurohormones and filling pres sures, Follow-vp investigations revealed a decrease of CA 125 levels after HTx (401 +/- 259 U/L vs 33 +/- 22 U/L, P <.001, n = 25) or stabilization (4 29 +/- 188 U/L vs 78 +/- 35 U/L P <.001 n = 25) and an increase during wors ening of heart failure (42 +/- 25 U/L vs 89 +/- 32 U/L, P <.01, n = 9). In 4 patients after HTx, unexpected death was preceded by rising CA 125 levels . CEA, CA 199, CA 153, TPS, or TPA did not correlate with heart failure sta tus or clinical events, Conclusions CA 125 is a marker of the clinical and hemodynamic status and t he course of patients with heart failure before and after heart transplanta tion. The determination of CA 125 serum levels may be an additional tool in the management of these patients, In patients with cancer, these "nonspeci fic" changes must be considered when CA 125 levels are determined. Whether CA 125 has a specific biologic role in heart failure deserves further studi es.