Clinical Studies On Serum CA125 In The Diagnosis Of Heart Failure With Preserved Ejection Fraction

Objective The relationship between CA125?NT-proBNP and echocardiographic parameters was analyzed through detecting serum CA125 levels in patient with heart failure with preserved ejection fraction(HFpEF)in order to futher evaluate the diagnostic value of serums CA125 in patient with HFpEF.Methods 120 patients with HFpEF hospitalized in our department of cardiovascular from September 2016 to October 2017,46 cases were male,and 74 cases were female.The patients with HFpEF were divided into three groups according to New York Heart Association(NYHA)classification;divided into 3 groups as grade II(n=30),grade ?(n=66),and grade?(n=24)according to New York Heart Association(NYHA)classification.120matched-control patients without heart failure who shared similar clinical characteristies(non-HF group)were included in the study,49 cases were male,and 71 cases were female.Patient's information with gender,age,smoking status,hypeirtension,the Coroary heart disease,atrial fibrillation,diabetes mellitus,hemoglobin,creatinine,NT-proBNP,serums CA125 and echocardiographic parameters were recorded as follows: left ventricular ejection fraction,left atrial diameter,left ventricular end-systolic diameter,left ventricular end-diastolic diameter,peak early diastolic mitral inflow velocity,peak late diastolic mitral inflow velocity,peak early diastolic mitral annular velocity,E/A,E/e?.To analyze the serum CA125 level in patients with HFpEF,to explore the relationship between them,and to further apply the receiver operating characteristic curve(ROC curve)to elucidate the the diagnostic value of combined detection of serum CA125 and NT-proBNP for HFpEF.Results The levels of CA125 and NT-proBNP in HFpEF group were significantly higher than those in non-HF group,the difference was statistically significant(P<0.05).Serums CA125 levels in patients with NYHA class IV was apparently greater than that in patients with cardiac function grade III and cardiac function grade II.The concentration of CA125 presented positively correlated with LVEDD,LAD,LgNT-proBNP and creatinine(r=0.251,0.353,0.347,0.327,0.248;P<0.05).On the contrary,it showed the negative correlation with EF and hemoglobin(r=-0.021,-0.175;P<0.05).The ROC curves of CA125 and NT-proBNPto diagnosis HFPEF were produced.The best cut off point for CA125 was 42.5 U/mL,the ROC curve was 0.849(95%C1 0.783~0.897,P<0.05),with a sensitivity of 81.35% and a specificity of 72.5%.The best cut off point for NT-proBNP was 725.46 U/mL,the ROC curve was 0.869(95%C1 0.846~0.932,P<0.05),with a sensitivity of 79.14% and a specificity of74%.The AUC of serumc CA125+NT-proBNP to diagnose HFpEF was 0.915(95 % C10.846~0.932,P<0.05)Conclusion(1)The level of serum CA125 in HFpEF patients were usually higher than those in non-HF patients.(2)The levels of serum CA125 in patients with HFpEF were remarkably correlated with the severity of heart failure.The levels of serum CA125 increases with the increase of NYHA cardiac function in HFpEF,and positively correlated with LgNT-proBNP,LAD and LVDD,and negatively correlated with LVEF.(3)Serum CA125 was the new biomarker for the diagnosis of HFpEF.The combined application of serum CA125 and NT-proBNP could improve the value diagnostic of HFpEF much more than the use of NT-proBNP alone.Serum CA125 could be a supplementary means of NT-proBNP,and improve the diagnostic value for HFpEF.