López-Vilella Raquel, González-Vílchez Francisco, Guerrero Cervera Borja, Donoso Trenado Víctor, Saura Carretero Zoser, Martínez-Solé Julia, Huélamo Montoro Sara, Martínez Dolz Luis, Almenar Bonet Luis
Cardiology Department, Hospital Universitari i Politècnic La Fe, Fernando Abril Martorell Avenue 106, 46026 Valencia, Spain.
Heart Failure and Transplant Unit, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain.
Life (Basel). 2025 Mar 18;15(3):494. doi: 10.3390/life15030494.
This study aims to analyze the factors associated with the lack of carbohydrate antigen 125 (CA-125) elevation in cases of acute heart failure (HF) decompensation. This retrospective study was conducted on 3167 consecutive patients admitted for acute HF in the cardiology department of a referral hospital (June 2019 to June 2024). Admissions from outpatient clinics (n: 1018) and transfers from other hospitals (n: 752) were excluded. The variables of interest included clinical, echocardiographic, therapeutic, and analytical factors. Low CA-125 levels were defined as values ≤ 50 U/mL. A total of 1397 patients were included, of whom 515 had normal CA-125 levels and 882 had elevated levels. Clinically, independent predictors of low CA-125 were sinus rhythm on electrocardiogram (OR: 1.42, 95% CI: 1.12-1.64; : 0.003) and sleep apnea-hyponpnea syndrome (OR: 1.76, 95% CI: 1.15-2.70; : 0.009). Echocardiographically, inferior vena cava collapse greater than 50% with inspiration was associated with low CA-125 (OR: 1.78, 95% CI: 1.19-2.69; = 0.005), as well as with non-severe right ventricular dysfunction. (OR: 2.42; IC95%: 1.39-4.20; : 0.002). Analytically, elevated NT-proBNP levels were associated with elevated CA-125 levels (OR: 0.99; IC95%: 0.99-0.99; : 0.006). Survival was higher in the group with CA-125 ≤ 50 U/mL (: 0.019). Conversely, as CA-125 values increased, mortality also rose. In conclusion, the absence of CA-125 elevation in patients admitted for acute HF is associated with sinus rhythm, sleep apnea-hyponpnea syndrome, low NT-proBNP levels, and inferior vena cava collapse greater than 50% with inspiration.
本研究旨在分析急性心力衰竭（HF）失代偿病例中与碳水化合物抗原125（CA - 125）未升高相关的因素。这项回顾性研究针对一家转诊医院心内科连续收治的3167例急性HF患者进行（2019年6月至2024年6月）。排除门诊入院患者（n = 1018）和从其他医院转入的患者（n = 752）。感兴趣的变量包括临床、超声心动图、治疗和分析因素。低CA - 125水平定义为≤50 U/mL。共纳入1397例患者，其中515例CA - 125水平正常，882例升高。临床上，低CA - 125的独立预测因素是心电图显示窦性心律（OR：1.42，95%CI：1.12 - 1.64；P = 0.003）和睡眠呼吸暂停低通气综合征（OR：1.76，95%CI：1.15 - 2.70；P = 0.009）。超声心动图方面，吸气时下腔静脉塌陷大于50%与低CA - 125相关（OR：1.78，95%CI：1.19 - 2.69；P = 0.005），也与非重度右心室功能障碍相关（OR：2.42；IC95%：1.39 - 【此处原文IC95%标注有误，推测应为95%CI】4.20；P = 0.002）。分析上，NT - proBNP水平升高与CA - 125水平升高相关（OR：0.99；IC95%：0.99 - 0.99；P = 0.006）。CA - 125≤50 U/mL组的生存率更高（P = 0.019）。相反，随着CA - 125值增加，死亡率也上升。总之，急性HF入院患者中CA - 125未升高与窦性心律、睡眠呼吸暂停低通气综合征、低NT - proBNP水平以及吸气时下腔静脉塌陷大于50%有关。 【说明：原文中部分表述如IC95%可能有误，推测应为95%CI，翻译时按推测修正后翻译，同时保留了原文中可能存在的错误表述供参考】
