CA125 levels among patients with advanced heart failure: an emerging independent predictor for survival.

Serum CA125, a high-molecular weight glycoprotein, is a tumor marker widely used for the diagnosis and follow-up of patients with ovarian cancer in clinical practice. Recently, increased serum CA125 values, in parallel with catecholamines and natriuretic peptides, have also been documented in patients with heart failure. As far as the relationship between CA125 and cardiac dysfunction is concerned; interleukin-6, interleukin-10, and tumor necrosis factor-α, which are all elevated in heart failure, might play a pivotal role, since there are data suggesting that the proliferation of CA125-producing cells is induced by proinflammatory cytokine network. However, little is known about the biologic role of this substance: whether it simply reflects the increased activation of the cytokine pathway (or other pathophysiologic pathways), or whether CA125 is an active substance truly responsible for myocardial and/or peripheral dysfunction. Further insight to the precise determinants for increased CA125 levels in this population would help establish the clinical usefulness of this emerging marker in predicting survival.