Clinical Study

High tumour burden, delayed diagnosis and history of cardiovascular disease may be associated with carcinoid heart disease

25 Oct 2018
Carolina Alves, Marcella Mesquita, Carolina Silva, Maria Soeiro, Ludhmila Hajjar, Rachel P Riechelmann

Background: Patients with carcinoid syndrome (CS) may present carcinoid heart disease (CHD) but prognostic factors are not entirely understood.

Patients and Methods: Retrospective study of patients with metastatic neuroendocrine tumours (NETs) and CS and/or abnormal 24-hoururinary 5-hydroxiindolacetic acid. CHD was defined as moderate to severe tricuspid or pulmonary regurgitation in the echocardiogram.

Results: The frequency of CHD among 42 patients was 38% (95% confidence interval [CI]: 23%–54%). CHD was associated with higher volume of liver metastases (odds ratio [OR] 13.86, 95% CI: 2.57–74.68, p = 0.002). Time from CS symptoms to NET diagnosis was borderline significant (p = 0.08). When CHD was defined as at least mild tricuspide regurgitation, the frequency of CHD was 45% and it was associated with cardiovascular comorbidities (OR: 6.58, 95% CI: 1.09; 39.78, p = 0.040).

Conclusion: CHD was frequent among patients with CS, significantly associated with high liver tumour burden, and likely linked to the history of cardiovascular disease and longer time of CS.

Article metrics: 393 views

Related Articles

Nicoletta Biglia, Valentina E Bounous, Francesco De Seta, Stefano Lello, Rossella E Nappi, Anna Maria Paoletti
Sergo Mkhitaryan, Samvel Danielyan, Lilit Sargsyan, Lusine Hakobyan, Samvel Iskanyan, Samvel Bardakchyan, Ruzanna Papyan, Jemma Arakelyan, Karmen Sahakyan, Tatevik Avagyan, Armen Tananyan, Armen Muradyan, Gevorg Tamamyan
Benjamin H Mullish, Laura S Osborne, Julian R Marchesi, Julie AK McDonald