Relation Between Level Of CA125and Heart Function As Well As BNP In Patients With Congestive Heart Failure

Background: Congestive heart failure (CHF) is a kind of complex clinical syndrome,which include terminal phase of all kinds of heart disease, Its incidence is high,five-year survival rate is paralleled to cancer,in Severe heart failure patients a yearsurvival rate is only50%. Myocardial remodeling is pathological manifestation ofheart failure, and neuroendocrine factor long-term excited and excessive activationare the main cause of myocardial remodeling, to explore new index of mayocardialremodeling becomes to be hot spots in recent years, BNP has been proved that plasmaconcentrations were positively correlated with severity of heart failure. It has reportedthat serum CA125are positively correlated with clinical symptoms and hemodynamyin heart failure patients, which may be another index except BNP.Objective To analyze the relationship between CA125and BNP, LVEF, LVEDD,LA through the dectection of serum CA125levels in CHF patients. Accoding to1~6months follow-up, To analyze the relationship between CA125and BNP,themortality rate in CHF patients.Methods145patients with CHF were divided into three groups based on thestandard of NYHA Classification；were divided into some groups based on the CA125levels(35U/ml) and/or BNP levels (400pg/ml)；were divided into some groups basedon the the kind of Heart failure. To test serum CA125and BNP levels among patientswith CHF and different kinds of heart failure. To measure the diastolic endstagediameter of left ventricular (LVEDD), inner diameter of left atrium (LA), leftventricular ejection fraction (LVEF) through the echocardiographic. To compareserum of CA125levels with BNP, LVEF,LVEDD, LA one by one. After1~6monthsfollow-up, served mortality and CHF rehospitalization as the end, to analyze therelationship between CA125and BNP,the mortality rate in CHF patients. Results①.The higher the serum of CA125,the higher NYHA functional class (I/II：18.79U/ml±5.23U/ml; III：82.34±24.37U/ml; IV：187.4±37.42U/ml; p=0.0001).②. In the overall of CHD: CA125is positively related with BNP（r=0.3433, p＜0.0001）and LVEF（r=-0.3176, p=0.0002）and LVEDD（r=0.0330, p＜0.001）and LA（r=0.263, p＜0.001）. In the different kind of heart failure:CA125and BNP showpositive correlation with Coronary artery disease、Hypertensive heart disease、Valvular heart disease and Other types of heart disease; the most significantly positivecorrelationship with Coronary artery disease（r=0.637，p=0.0001）, No correlationshipwith the dilated cardiomyopathy（p=0.12）; CA125and LVEF show the negativecorrelation with Hypertensive heart disease（r=-0.484，p=0.0001）; and LVEDD showthe positive correlation in Coronary artery disease（r=0.392，p=0.014）; and LA showthe positive correlation with the Dilated cardiomyopathy（r=0.398，p=0.044）.③. Significantly higher serum CA125levels were found in patients with pleuraleffusion when compared to patients without pleural effusion (p=0.003).④.After1~6months of follow-up, the rate of rehospitalization in patients with CHFbecomed to be higher with the increase of serum CA125（p=0.011）, the rate ofrehospitalization in patients with CHF becomed to be higher with the increase ofserum BNP（p=0.001）,the combination CA125with BNP are showed the moreaccurately predictable value of CHF rehospitalization（p=0.00012）.Conclusion①.Serum levels of CA125are associated with the severity of CHF, which may beanother index of the diagnosis, prognosis in CHF patients.②.The higher the serum of CA125,the higher NYHA functional class; BNP,LVEDD, LA show the positive correlationship, but LVEF show the negativecorrelation; In the different kind of heart failure:CA125and BNP show positivecorrelation with Coronary artery disease、Hypertensive heart disease、Valvular heart disease and Other types of heart disease;the most significantly positivecorrelationship with Coronary artery disease, No correlationship with the dilatedcardiomyopathy; CA125and LVEF show the negative correlation withHypertensive heart disease; and LVEDD show the positive correlation inCoronary artery disease; and LA show the positive correlation with the Dilatedcardiomyopathy.③.Significantly higher serum CA125levels were found in patients with pleuraleffusion when compared to patients without pleuraul effusion.④.The serum of CA125、BNP level can be used to predict the prognosis of severityof patients with heart failure,the combination CA125with BNP are showed themore accurately predictable value of CHF rehospitalization.