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Invited Commentary| Volume 224, ISSUE 2, P664, August 2022

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Carcinoid heart disease: The rare and obscure becomes screened and well known

Published:February 12, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.02.003
Carcinoid heart disease: The rare and obscure becomes screened and well known
Previous ArticleConservative management of malignant colorectal polyps in select cases is safe in long-term follow-up: An institutional review
Next ArticleThe prevalence, operations, and outcomes of carcinoid heart disease
      Carcinoid heart disease (CHD) is an insidious complication of carcinoid syndrome (CS) where myoproliferative plaques accumulate on the tricuspid and pulmonic valves as well as on the right ventricular endocardium and pulmonary artery intima.
      • Grozinsky-Glasberg S.
      • Grossman A.
      • Gross D.
      Carcinoid heart disease: from pathophysiology to treatment- ‘something in the way it moves.
      Neuroendocrinology. 2015; 101: 263-273
      The pathophysiology has historically been obscure, but neuroendocrine tumor experts have recently concluded, supported by both human clinical data and animal studies, that the plaques are likely induced by elevated levels of 5-hydroxytrytophan (serotonin) or other substances secreted by the tumor such as prostaglandins, bradykinin, and substance P.
      • Grozinsky-Glasberg S.
      • Grossman A.
      • Gross D.
      Carcinoid heart disease: from pathophysiology to treatment- ‘something in the way it moves.
      Neuroendocrinology. 2015; 101: 263-273
      ,
      • Davar J.
      • Connolly H.
      • Caplin M.
      • et al.
      Diagnosing and managing carcinoid heart disease in patients with neuroendocrine tumors.
      J Am Coll Cardiol. 2017; 69: 1288-1304
      In more severe cases CHD may progress to right heart failure within several months.
      • Dobson R.
      • Burgess M.
      • Valle J.
      • et al.
      Serial surveillance of carcinoid heart disease: factors associated with echocardiographic progression and mortality.
      Br J Cancer. 2014; 111: 1703-1709
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      References

        • Grozinsky-Glasberg S.
        • Grossman A.
        • Gross D.
        Carcinoid heart disease: from pathophysiology to treatment- ‘something in the way it moves.
        Neuroendocrinology. 2015; 101: 263-273
        View in Article
        • Davar J.
        • Connolly H.
        • Caplin M.
        • et al.
        Diagnosing and managing carcinoid heart disease in patients with neuroendocrine tumors.
        J Am Coll Cardiol. 2017; 69: 1288-1304
        View in Article
        • Dobson R.
        • Burgess M.
        • Valle J.
        • et al.
        Serial surveillance of carcinoid heart disease: factors associated with echocardiographic progression and mortality.
        Br J Cancer. 2014; 111: 1703-1709
        View in Article
        • Macfie R.
        • McCully B.
        • Ratzlaff A.
        • et al.
        The incidence, operations, and outcomes of carcinoid heart disease.
        Am J Surg. 2022; 224: 665-669
        View in Article
        • Dawod M.
        • Gordoa T.
        • Cives M.
        • et al.
        Antiproliferative systemic therapies for metastatic small bowel neuroendocrine tumours.
        Curr Treat Options Oncol. 2021; 22 (published online): 73
        View in Article
        • Diamantopoulos L.
        • Laskaratos F.
        • Kalligerous M.
        • et al.
        Antiproliferative effect of above-label doses of somatostatin analogs for the management of gastroenteropancreatic neuroendocrine tumors.
        Neuroendocrinology. 2021; 111: 650-659
        View in Article

      Article info

      Publication history

      Published online: February 12, 2022
      Accepted: February 5, 2022
      Received: February 4, 2022

      Identification

      DOI: https://doi.org/10.1016/j.amjsurg.2022.02.003

      Copyright

      © 2022 Elsevier Inc. All rights reserved.

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