PMID: 7538079Feb 1, 1995Paper

Cardiac manifestations in mid-gut carcinoid disease

European Heart Journal
M B JacobsenL E Hanssen

Abstract

The extent of heart disease and its relationship to the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA), was studied with M-mode, 2D and Doppler echocardiography in 42 consecutive patients, 30 females and 12 males, median age 63 (range 23-75) years with histologically verified mid-gut tumour, liver metastases and 24-h urinary 5-HIAA excretion above 47 mumol.24 h-1. All patients had normal left ventricular ejection fractions, median 65% (interquartile range (IQR) 54-74%). Moderate to severe tricuspid regurgitation (TR) was diagnosed in 22 patients (59%); mitral or aortic regurgitation was found in nine (24%) and six (16%) patients, respectively. The mitral flow peak early (E) on late (A) velocity ratio was significantly decreased compared to age-matched normal subjects. The group of patients with 5-HIAA excretion exceeding 1000 mumol.24h-1 contained significantly more patients with severe TR than those with a lower excretion. The decrease in the E/A ratio may indicate reduced left ventricular compliance, possibly secondary to fibrous changes similar to those seen intra-abdominally and in the right side of the heart. As serotonin is degraded in the lung circulation, other mediators such as tachykinins and cytokines (PDGF...Continue Reading

Citations

Aug 18, 2000·Anaesthesia·D J VaughanM D Brunner
Nov 8, 2017·Cancer·Faidon-Marios LaskaratosDalvinder Mandair
Oct 17, 2014·Endocrine·Jan CalissendorffHenrik Falhammar
Sep 18, 1997·Diseases of the Colon and Rectum·M A Memon, H Nelson
Jun 2, 2011·Deutsches Ärzteblatt International·Matthias SchottWerner A Scherbaum
May 25, 2010·The American Journal of Cardiology·Nicolas MansencalOlivier Dubourg

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