MiscellaneousRisk Factors for the Development and Progression of Carcinoid Heart Disease
Section snippets
Methods
We conducted an observational cohort study. Patients with histologically proved metastatic carcinoid tumor of midgut origin and carcinoid syndrome were consecutively and prospectively recruited from the neuroendocrine tumor clinic at the Royal Free Hospital (London, United Kingdom) from April 2006 through January 2010. All patients gave written informed consent for the study. The study was approved by the institution's local ethics committee.
All patients were evaluated at 4- to 6-month
Results
Two hundred fifty-two patients were recruited. Median follow-up was 29 months (interquartile range 24 to 36). At baseline 41 patients had carcinoid heart disease. Forty-four patients developed carcinoid heart disease during the study period or had progression of existing carcinoid heart disease (15 patients developed and 29 patients had progression). Thirty-four patients died during the study period (13 patients had carcinoid heart disease). Twenty-two patients underwent cardiac valve
Discussion
The development of carcinoid heart disease and subsequent development of right-sided heart failure is a major cause of morbidity in patients with carcinoid syndrome. Risk factors for development and progression of carcinoid heart disease are poorly defined.
In a retrospective analysis Moller et al6 demonstrated that progression of carcinoid heart disease is related to increased levels of urinary 5-HIAA and use of chemotherapy. Denney et al13 performed a prospective study, although only 23
Acknowledgment
We are grateful for statistical advice provided by Colette Smith, PhD, Department of Infection and Population Health, UCL Medical School.
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