Echocardiographic follow-up of treated patients with carcinoid syndrome.
Carcinoid heart disease is a rare disease, and its prevalence is uncertain. The aim of the present prospective study was to assess the prevalence of carcinoid heart disease using annual echocardiographic follow-up. We studied 80 consecutive patients presenting with histologically proven digestive endocrine tumor and carcinoid syndrome. All patients underwent annual conventional transthoracic echocardiographic studies and measurement of biologic carcinoid markers. Right- and left-sided carcinoid heart disease and the score of the severity of carcinoid heart disease were systematically assessed. At baseline, the prevalence of right- and left-sided carcinoid heart disease was 33% and 8%, respectively. At the end of follow-up, the corresponding prevalence was 53% and 21%. The correlations were strong between urinary 5-hydroxyindoleacetic acid (5-HIAA) and the right-sided carcinoid heart disease score (r = 0.75, p <0.0001), between urinary 5-HIAA and the left-sided carcinoid heart disease score (r = 0.83, p = 0.001), and between urinary 5-HIAA and the overall carcinoid heart disease score (r = 0.84, p <0.0001). All patients with > or =3 years of carcinoid syndrome and increased level of urinary 5-HIAA presented with echocardiographic evidence of valve disease on routine monitoring. In conclusion, the prevalence of carcinoid heart disease remained high and increased during follow-up. Carcinoid heart disease progresses over time, highlighting the need for echocardiographic follow-up once carcinoid syndrome has been diagnosed.
Mansencal
Nicolas
N
Department of Cardiology, Université de Versailles-Saint Quentin, Hôpital Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Boulogne, France. nicolas.mansencal@apr.aphp.fr
Mitry
Emmanuel
E
Bachet
Jean-Baptiste
JB
Rougier
Philippe
P
Dubourg
Olivier
O
D000368:Aged; D015415:Biomarkers / Q000652:urine; D002275:Carcinoid Heart Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery / Q000652:urine*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006338:Heart Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery / Q000652:urine*; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine*; D008297:Male; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index
D015415:Biomarkers; D006897:Hydroxyindoleacetic Acid