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Serial surveillance of carcinoid heart disease: factors associated with echocardiographic progression and mortality

BACKGROUND: Carcinoid heart disease is a complication of metastatic neuroendocrine tumours (NETs). We sought to identify factors associated with echocardiographic progression of carcinoid heart disease and death in patients with metastatic NETs. METHODS: Patients with advanced non-pancreatic NETs an...

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Autores principales: Dobson, R, Burgess, M I, Valle, J W, Pritchard, D M, Vora, J, Wong, C, Chadwick, C, Keevi, B, Adaway, J, Hofmann, U, Poston, G J, Cuthbertson, D J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4453728/
https://www.ncbi.nlm.nih.gov/pubmed/25211656
http://dx.doi.org/10.1038/bjc.2014.468
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author Dobson, R
Burgess, M I
Valle, J W
Pritchard, D M
Vora, J
Wong, C
Chadwick, C
Keevi, B
Adaway, J
Hofmann, U
Poston, G J
Cuthbertson, D J
author_facet Dobson, R
Burgess, M I
Valle, J W
Pritchard, D M
Vora, J
Wong, C
Chadwick, C
Keevi, B
Adaway, J
Hofmann, U
Poston, G J
Cuthbertson, D J
author_sort Dobson, R
collection PubMed
description BACKGROUND: Carcinoid heart disease is a complication of metastatic neuroendocrine tumours (NETs). We sought to identify factors associated with echocardiographic progression of carcinoid heart disease and death in patients with metastatic NETs. METHODS: Patients with advanced non-pancreatic NETs and documented liver metastases and/or carcinoid syndrome underwent prospective serial clinical, biochemical, echocardiographic and radiological assessment. Patients were categorised as carcinoid heart disease progressors, non-progressors or deceased. Multinomial regression was used to assess the univariate association between variables and carcinoid heart disease progression. RESULTS: One hundred and thirty-seven patients were included. Thirteen patients (9%) were progressors, 95 (69%) non-progressors and 29 (21%) patients deceased. Baseline median levels of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and plasma 5-hydroxyindoleacetic acid (5-HIAA) were significantly higher in the progressors. Every 100 nmol l(−1) increase in 5-HIAA yielded a 5% greater odds of disease progression (OR 1.05, 95% CI: 1.01, 1.09; P=0.012) and a 7% greater odds of death (OR 1.07, 95% CI: 1.03, 1.10; P=0.001). A 100 ng l(−1) increase in NT-proBNP did not increase the risk of progression, but did increase the risk of death by 11%. CONCLUSIONS: The biochemical burden of disease, in particular baseline plasma 5-HIAA concentration, is independently associated with carcinoid heart disease progression and death. Clinical and radiological factors are less useful prognostic indicators of carcinoid heart disease progression and/or death.
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spelling pubmed-44537282015-10-28 Serial surveillance of carcinoid heart disease: factors associated with echocardiographic progression and mortality Dobson, R Burgess, M I Valle, J W Pritchard, D M Vora, J Wong, C Chadwick, C Keevi, B Adaway, J Hofmann, U Poston, G J Cuthbertson, D J Br J Cancer Clinical Study BACKGROUND: Carcinoid heart disease is a complication of metastatic neuroendocrine tumours (NETs). We sought to identify factors associated with echocardiographic progression of carcinoid heart disease and death in patients with metastatic NETs. METHODS: Patients with advanced non-pancreatic NETs and documented liver metastases and/or carcinoid syndrome underwent prospective serial clinical, biochemical, echocardiographic and radiological assessment. Patients were categorised as carcinoid heart disease progressors, non-progressors or deceased. Multinomial regression was used to assess the univariate association between variables and carcinoid heart disease progression. RESULTS: One hundred and thirty-seven patients were included. Thirteen patients (9%) were progressors, 95 (69%) non-progressors and 29 (21%) patients deceased. Baseline median levels of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and plasma 5-hydroxyindoleacetic acid (5-HIAA) were significantly higher in the progressors. Every 100 nmol l(−1) increase in 5-HIAA yielded a 5% greater odds of disease progression (OR 1.05, 95% CI: 1.01, 1.09; P=0.012) and a 7% greater odds of death (OR 1.07, 95% CI: 1.03, 1.10; P=0.001). A 100 ng l(−1) increase in NT-proBNP did not increase the risk of progression, but did increase the risk of death by 11%. CONCLUSIONS: The biochemical burden of disease, in particular baseline plasma 5-HIAA concentration, is independently associated with carcinoid heart disease progression and death. Clinical and radiological factors are less useful prognostic indicators of carcinoid heart disease progression and/or death. Nature Publishing Group 2014-10-28 2014-09-11 /pmc/articles/PMC4453728/ /pubmed/25211656 http://dx.doi.org/10.1038/bjc.2014.468 Text en Copyright © 2014 Cancer Research UK http://creativecommons.org/licenses/by-nc-sa/3.0/ From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/
spellingShingle Clinical Study
Dobson, R
Burgess, M I
Valle, J W
Pritchard, D M
Vora, J
Wong, C
Chadwick, C
Keevi, B
Adaway, J
Hofmann, U
Poston, G J
Cuthbertson, D J
Serial surveillance of carcinoid heart disease: factors associated with echocardiographic progression and mortality
title Serial surveillance of carcinoid heart disease: factors associated with echocardiographic progression and mortality
title_full Serial surveillance of carcinoid heart disease: factors associated with echocardiographic progression and mortality
title_fullStr Serial surveillance of carcinoid heart disease: factors associated with echocardiographic progression and mortality
title_full_unstemmed Serial surveillance of carcinoid heart disease: factors associated with echocardiographic progression and mortality
title_short Serial surveillance of carcinoid heart disease: factors associated with echocardiographic progression and mortality
title_sort serial surveillance of carcinoid heart disease: factors associated with echocardiographic progression and mortality
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4453728/
https://www.ncbi.nlm.nih.gov/pubmed/25211656
http://dx.doi.org/10.1038/bjc.2014.468
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