Serum CA 125 Levels in Patients with Chronic Heart Failure and Accompanying Pleural Fluid

Abstract

Malignant and nonmalignant serosal fluids have been found to be associated with high serum levels of CA 125, suggesting that the presence of fluid in the serosal cavities may stimulate its release. In this study, we investigated the relationship between serum CA 125 levels and the presence of pleural fluid in patients with chronic heart failure (CHF). We performed a clinical study in 36 patients with CHF with and without pleural fluid. Patients with CHF were divided into two groups based on the presence of fluid in the pleural cavity. Group 1 included 18 CHF patients (6 females, 12 males) with pleural fluid. Group 2 consisted of 18 CHF patients (7 females, 11 males) without pleural fluid. The control group consisted of 30 healthy volunteers (12 females, 18 males). The serum CA 125 level was determined in all groups. Serum CA 125 levels were found to be 100.0 ± 129.4 U/ml in CHF patients with pleural fluids, whereas they were 36.5 ± 35.2 U/ml in CHF patients without pleural fluid and 8.9 ± 6.1 U/ml in the control group. Significantly high serum CA 125 levels were found in CHF patients with pleural fluids (p < 0.05) when compared with both CHF patients without pleural fluid and the control group. There was also a statistically significant difference in CA 125 levels between patients without pleural fluid and the control group (p < 0.05). We concluded that serum CA 125 levels should be interpreted with caution in patients with CHF in the presence of pleural fluid. Invasive procedures to define the etiology of elevated serum CA 125 levels may be unnecessary in this patient group.

Effects of ivabradine therapy on heart failure biomarkers

“…It has become increasingly clear that mechanical stress and inflammatory stimuli together initiate CA-125 synthesis [34]. In the course of HF, CA-125 is positively correlated with the NYHA functional class, the presence of pleural effusion, and pulmonary capillary wedge pressure [35,36]. Nunez et al [37] found significant differences in CA-125 levels in patients with and without HF; patients with acute HF exhibited a 7-fold increase in mean CA-125 serum levels in comparison with control subjects.…”

Prognostic value of increased carbohydrate antigen in patients with heart failure

“…Increased CA125 concentration in patients with HF is believed to be multifactorial and secondary to the increased end-diastolic and pulmonary venocapillary pressure that causes interstitial pulmonary edema [31] , an inflammatory substrate present in HF. In addition, the appearance of pleural effusion and signs of congestion have been associated with increased CA125 [32] . The good correlation of CA125 with natriuretic peptides suggests a similar release mechanism related to an increase in intracavitary pressures and stress of both atrial and ventricular walls.…”

CA 125 levels and left ventricular function in patients with end-stage renal disease on maintenance hemodialysis

“…According to our results, there was a significant correlation between CA 125 serum levels and HF, including the correlation between this tumoral marker and BNP values. Many reports 12,14,19,36,37 have suggested that serosal fluids occurring in patients with HF are directly responsible for elevated serum CA 125 levels and that the presence of serosal fluid may stimulate the release of CA 125 rather than its cytopathological content. Recent studies have suggested that CHF may, in part, be an inflammatory disease.…”