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Abstract：
BACKGROUND: Carcinoid heart disease (CHD) caused by neuroendocrine tumours (NET) is associated with an increased morbidity and mortality due to valvular dysfunction and right sided heart failure. The present study aimed to assess the prevalence and one-year-incidence of CHD in NET patients. Tumour characteristics, laboratory measurements, and echocardiographic findings were evaluated to identify predictors of CHD manifestation.
METHODS: The study was an investigator-initiated, monocentric, prospective trial. Patients with NET without previously diagnosed CHD were included and underwent comprehensive gastroenterological and oncological diagnostics. Echocardiographic examinations were performed at baseline and after one year.
RESULTS: Forty-seven NET patients were enrolled into the study, 64% of them showed clinical features of a carcinoid syndrome (CS). Three patients presented with CHD at baseline and three patients developed cardiac involvement during the follow-up period corresponding to a prevalence of 6% at baseline and an incidence of 6.8% within one year. Hydroxyindoleacetic acid (5-HIAA) was identified to predict the occurrence of CHD (OR, 1.004; 95% CI, 1.001-1.006 for increase of 5-HIAA), while chromogranin A (CgA), and Kiel antigen 67 (Ki 67%) had no predictive value. Six patients with CHD at twelve-month follow-up revealed a tendency for larger right heart diameters and increased values of myocardial performance index (MPEI) at baseline compared to NET patients.
CONCLUSIONS: The prevalence at baseline and one-year-incidence of CHD was 6-7%. 5-HIAA was identified as the only marker which predict the development of CHD.
METHODS: The study was an investigator-initiated, monocentric, prospective trial. Patients with NET without previously diagnosed CHD were included and underwent comprehensive gastroenterological and oncological diagnostics. Echocardiographic examinations were performed at baseline and after one year.
RESULTS: Forty-seven NET patients were enrolled into the study, 64% of them showed clinical features of a carcinoid syndrome (CS). Three patients presented with CHD at baseline and three patients developed cardiac involvement during the follow-up period corresponding to a prevalence of 6% at baseline and an incidence of 6.8% within one year. Hydroxyindoleacetic acid (5-HIAA) was identified to predict the occurrence of CHD (OR, 1.004; 95% CI, 1.001-1.006 for increase of 5-HIAA), while chromogranin A (CgA), and Kiel antigen 67 (Ki 67%) had no predictive value. Six patients with CHD at twelve-month follow-up revealed a tendency for larger right heart diameters and increased values of myocardial performance index (MPEI) at baseline compared to NET patients.
CONCLUSIONS: The prevalence at baseline and one-year-incidence of CHD was 6-7%. 5-HIAA was identified as the only marker which predict the development of CHD.
摘要：
背景：由神经内分泌肿瘤（NET）引起的类癌性心脏病（CHD）与由于瓣膜功能障碍和右侧心力衰竭引起的发病率和死亡率增加相关。本研究旨在评估NET患者CHD的患病率和一年发病率。肿瘤特征,实验室测量，和超声心动图检查结果进行评估以确定CHD表现的预测因子。
方法：该研究由研究者发起，单心,前瞻性审判。纳入先前未诊断为CHD的NET患者，并进行了全面的胃肠病学和肿瘤学诊断。在基线和一年后进行超声心动图检查。
结果：47名NET患者被纳入研究，其中64％表现出类癌综合征（CS）的临床特征。3例患者在基线时出现CHD，3例患者在随访期间出现心脏受累，基线时患病率为6%，一年内发病率为6.8%。羟基吲哚乙酸（5-HIAA）被鉴定为预测冠心病的发生（OR，1.004；95%CI，5-HIAA增加1.001-1.006），而嗜铬粒蛋白A（CGA），Kiel抗原67(Ki67%)无预测价值。与NET患者相比，在12个月的随访中，六名CHD患者显示出基线时右心直径更大，心肌性能指数（MPEI）值增加的趋势。
结论：冠心病的基线患病率和一年发病率为6-7%。5-HIAA被鉴定为预测CHD发展的唯一标记。
方法：该研究由研究者发起，单心,前瞻性审判。纳入先前未诊断为CHD的NET患者，并进行了全面的胃肠病学和肿瘤学诊断。在基线和一年后进行超声心动图检查。
结果：47名NET患者被纳入研究，其中64％表现出类癌综合征（CS）的临床特征。3例患者在基线时出现CHD，3例患者在随访期间出现心脏受累，基线时患病率为6%，一年内发病率为6.8%。羟基吲哚乙酸（5-HIAA）被鉴定为预测冠心病的发生（OR，1.004；95%CI，5-HIAA增加1.001-1.006），而嗜铬粒蛋白A（CGA），Kiel抗原67(Ki67%)无预测价值。与NET患者相比，在12个月的随访中，六名CHD患者显示出基线时右心直径更大，心肌性能指数（MPEI）值增加的趋势。
结论：冠心病的基线患病率和一年发病率为6-7%。5-HIAA被鉴定为预测CHD发展的唯一标记。
