PDF(Pubmed)
Abstract：
UNASSIGNED: Screening for carcinoid heart disease (CHD), has historically lacked consensus expert guidelines. In 2017, the North American Neuroendocrine Tumor Society (NANETS) released expert recommendations for CHD screening among NET patients to improve CHD detection. The objective of this study is to evaluate CHD screening trends and utility of screening guidelines over more than two decades at a single tertiary care center.
UNASSIGNED: Patients with NETs referred for abdominal surgical evaluation at a single tertiary care center were included, 300 patients from 1999 to 2018 and 34 patients from 2021 to 2022. Lab values for the following NANETS-proposed criteria at any point during their treatments were recorded: NETs with liver metastasis, blood serotonin >5 times upper limit of normal (>1000 ng/mL), NT-ProBNP >260 pg/mL and clinical features suggestive of CHD.
UNASSIGNED: 85 % (285/334) of patients included in this study met one or more expert-recommended CHD screening criteria. However, 40 % (132/285) of patients meeting one or more criteria received CHD screening via echocardiogram at some point following NET diagnosis. While rates of screening for patients increased from the first decade to the second decade (32 % vs 40.6 %), the rates were much higher after guideline publication (70 %, 24/34). Furthermore, patients meeting multiple screening criteria were more likely to have evidence of structural valve disease.
UNASSIGNED: Results of this study suggest that utilization of these four expert-recommended screening criteria have greatly increased rates of CHD screening via echocardiogram and could assist in improving early CHD detection, especially for patients meeting multiple criteria.
UNASSIGNED: Patients with NETs referred for abdominal surgical evaluation at a single tertiary care center were included, 300 patients from 1999 to 2018 and 34 patients from 2021 to 2022. Lab values for the following NANETS-proposed criteria at any point during their treatments were recorded: NETs with liver metastasis, blood serotonin >5 times upper limit of normal (>1000 ng/mL), NT-ProBNP >260 pg/mL and clinical features suggestive of CHD.
UNASSIGNED: 85 % (285/334) of patients included in this study met one or more expert-recommended CHD screening criteria. However, 40 % (132/285) of patients meeting one or more criteria received CHD screening via echocardiogram at some point following NET diagnosis. While rates of screening for patients increased from the first decade to the second decade (32 % vs 40.6 %), the rates were much higher after guideline publication (70 %, 24/34). Furthermore, patients meeting multiple screening criteria were more likely to have evidence of structural valve disease.
UNASSIGNED: Results of this study suggest that utilization of these four expert-recommended screening criteria have greatly increased rates of CHD screening via echocardiogram and could assist in improving early CHD detection, especially for patients meeting multiple criteria.
摘要：
■类癌心脏病（CHD）筛查，历史上缺乏共识的专家指南。2017年，北美神经内分泌肿瘤协会（NANETS）发布了在NET患者中进行CHD筛查的专家建议，以改善CHD检测。这项研究的目的是评估冠心病筛查趋势和筛查指南的实用性超过二十年在一个三级护理中心。
■纳入了在单一三级护理中心进行腹部手术评估的NETs患者，1999年至2018年有300名患者，2021年至2022年有34名患者。在治疗期间的任何时间点记录以下NANETS提出的标准的实验室值：具有肝转移的NETs，血5-羟色胺>5倍的正常上限（>1000ng/mL），NT-ProBNP>260pg/mL，临床特征提示冠心病。
■纳入本研究的患者中有85%（285/334）符合一项或多项专家建议的冠心病筛查标准。然而,40%(132/285)符合一个或多个标准的患者在NET诊断后的某个时间点通过超声心动图接受了CHD筛查。虽然从第一个十年到第二个十年，患者的筛查率增加了（32％vs40.6％），指南公布后，这一比例要高得多(70%，24/34).此外，符合多种筛查标准的患者更可能有结构性瓣膜疾病的证据.
■这项研究的结果表明，利用这四个专家建议的筛查标准大大提高了通过超声心动图筛查CHD的比率，并有助于改善早期CHD检测。特别是对于符合多个标准的患者。
■纳入了在单一三级护理中心进行腹部手术评估的NETs患者，1999年至2018年有300名患者，2021年至2022年有34名患者。在治疗期间的任何时间点记录以下NANETS提出的标准的实验室值：具有肝转移的NETs，血5-羟色胺>5倍的正常上限（>1000ng/mL），NT-ProBNP>260pg/mL，临床特征提示冠心病。
■纳入本研究的患者中有85%（285/334）符合一项或多项专家建议的冠心病筛查标准。然而,40%(132/285)符合一个或多个标准的患者在NET诊断后的某个时间点通过超声心动图接受了CHD筛查。虽然从第一个十年到第二个十年，患者的筛查率增加了（32％vs40.6％），指南公布后，这一比例要高得多(70%，24/34).此外，符合多种筛查标准的患者更可能有结构性瓣膜疾病的证据.
■这项研究的结果表明，利用这四个专家建议的筛查标准大大提高了通过超声心动图筛查CHD的比率，并有助于改善早期CHD检测。特别是对于符合多个标准的患者。
