942-39 Carcinoid Heart Disease: Correlation of High Serotonin Levels with Valvular Abnormalities Detected by Cardiac Catheterization and Echocardiography

MRI and CT revealing carcinoid heart disease

“…Although carcinoid heart disease is associated with higher 5-HIAA excretion in urine among patients with carcinoid syndrome [6], treatment reducing 5-HIAA excretion does not result in regression of cardiac lesions [2]. Diuretics temporarily improve symptoms of carcinoid heart disease and valvular replacement remains the only effective treatment, but it is associated with high perioperative morbidity and mortality, particularly in older patients [7].…”

Cardiac surgery for carcinoid heart disease in 12 cases

“…6 Carcinoid heart disease is seen in approximately 50% of those who suffer from carcinoid syndrome, 7-10 which in turn occurs in 20% to 30% of patients with carcinoid tumor. 5 Long-lasting exposure to high levels of serotonin, which produces proliferative endocardial lesions, [8][9][10][11]12 causes carcinoid heart disease 3,8,9,11 ; i.e., formation of fi brotic plaques 7,10,13 on the heart valves results in shortening and thickening of the heart valves and fi nally incompetence of the valves. 3,5,7,8,10,11,13,14 Because morphological change of the heart valves caused by the endothelial plaques is irreversible even by lowering serotonin levels by somatostatin therapy and hepatic dearterialization, 10,11 valve surgery is the main treatment for carcinoid heart disease.…”

“…1 It is well known that cardiac surgery in carcinoid heart disease carries high perioperative mortality. [1][2][3][4][5] We retrospectively reviewed 12 patients with carcinoid heart disease who had undergone valvular surgery in the past 9 years.…”

Report and Recommendations of the Workshop of the European Centre for the Validation of Alternative Methods for Drug-Induced Cardiotoxicity

“…Valvular disease can develop in carcinoid syndrome due to increased serotonin levels [18], and also in patients treated with serotonin-like agents such as ergotamine and methysergide [19]. Over the last decade it has become well established that agonists of the 5-HT 2B (5-hydroxytryptamine) receptor can cause valvular heart disease [20].…”