Serial surveillance of carcinoid heart disease: factors associated with echocardiographic progression and mortality.
Br J Cancer
; 111(9): 1703-9, 2014 Oct 28.
Article
en En
| MEDLINE
| ID: mdl-25211656
ABSTRACT
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.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Cardiopatía Carcinoide
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Ecocardiografía
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Tumores Neuroendocrinos
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Neoplasias Hepáticas
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Límite:
Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
Br J Cancer
Año:
2014
Tipo del documento:
Article
País de afiliación:
Reino Unido