Echocardiographic and biochemical evaluation of the development and progression of carcinoid heart disease

Abstract

We designed a new echocardiographic scoring system to evaluate CVHD. Correlating echocardiographic scores with biochemical and clinical markers showed that only posttreatment 5-HIAA levels independently predicted the development or progression of CVHD. This study strengthens the association between serotonin secretion and CVHD, as well as introducing a new technique for serial follow-up of these patients.

Carcinoid heart disease: two clinical cases and a review

“…17 Indirect evidence of the role of serotonin in the pathogenesis of valvular damage is that patients with cardiac involvement tend to have higher levels of urinary 5-HIAA than those without cardiac involvement. 10,15,19,20 Drugs known to inhibit the metabolism of serotonin, e.g. fenfluramine and dexfenfluramine, predispose to identical valvular heart lesions.…”

Consensus Recommendations for the Diagnosis and Management of Well-Differentiated Gastroenterohepatic Neuroendocrine Tumours: A Revised Statement from a Canadian National Expert Group

“…The severity of carcinoid syndrome symptomatology correlates with the level of 5-hiaa elevation. There is also evidence that long-standing significant elevations in 5-hiaa may be associated with carcinoid heart disease [39][40][41][42] .…”

“…Although symptoms may be controlled without normalizing urinary 5-hiaa, elevated 5-hiaa has been associated with progression of carcinoid heart disease; it is therefore important to try to normalize this value 41 . Some patients with elevated 5-hiaa may be asymptomatic; the role of ssas in this group of patients is controversial.…”

“…Patients with elevated 5-hiaa levels remain at risk for carcinoid heart disease 33,[39][40][41][42]74,75 . Case series of patients with carcinoid heart disease have described an association between elevated 5-hiaa and the development and pathogenesis of carcinoid heart disease 33,[39][40][41][42] .…”

“…Case series of patients with carcinoid heart disease have described an association between elevated 5-hiaa and the development and pathogenesis of carcinoid heart disease 33,[39][40][41][42] . Therapy with ssa reduces circulating serotonin levels and may stabilize the progression of carcinoid heart disease 74,75 .…”