Arterial function, biomarkers, carcinoid syndrome and carcinoid heart disease in patients with small intestinal neuroendocrine tumours

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Kostiainen , I , Karppinen , N , Simonen , P , Rosengård-Bärlund , M , Linden , R , Tarkkanen , M , Gordin , D , Rapola , J , Schalin-Jäntti , C & Matikainen , N 2022 , ' Arterial function, biomarkers, carcinoid syndrome and carcinoid heart disease in patients with small intestinal neuroendocrine tumours ' , Endocrine , vol. 77 , no. 1 , pp. 177-187 . https://doi.org/10.1007/s12020-022-03065-0

Title: Arterial function, biomarkers, carcinoid syndrome and carcinoid heart disease in patients with small intestinal neuroendocrine tumours
Author: Kostiainen, Iiro; Karppinen, Noora; Simonen, Piia; Rosengård-Bärlund, Milla; Linden, Riikka; Tarkkanen, Maija; Gordin, Daniel; Rapola, Janne; Schalin-Jäntti, Camilla; Matikainen, Niina
Contributor organization: Clinicum
University of Helsinki
HUS Abdominal Center
Endokrinologian yksikkö
HUS Heart and Lung Center
Department of Medicine
Kardiologian yksikkö
HUS Medical Imaging Center
Department of Diagnostics and Therapeutics
HUS Diagnostic Center
Department of Oncology
HUS Comprehensive Cancer Center
Nefrologian yksikkö
Date: 2022-06
Language: eng
Number of pages: 11
Belongs to series: Endocrine
ISSN: 1355-008X
DOI: https://doi.org/10.1007/s12020-022-03065-0
URI: http://hdl.handle.net/10138/346051
Abstract: Purpose Carcinoid heart disease (CHD) is a life-threatening complication of carcinoid syndrome (CS) characterised by tricuspid regurgitation (TR). However, there is an unmet need for earlier diagnosis of CHD. We cross-sectionally assessed the prevalence and potential predictive or diagnostic markers for CS and CHD in a contemporary cohort of patients with small intestinal neuroendocrine tumours (SI-NETs). Methods Biochemical characteristics, hepatic tumour load, measures of arterial and endothelial function, atherosclerosis, and transthoracic echocardiography were analysed in a prospective cross-sectional setting. Results Among the 65 patients studied, 29 (45%) had CS (CS+), and 3 (5%) CHD. CS+ was characterised by significantly higher hepatic tumour load, S-5-HIAA and fP-CgA, higher frequency of diarrhoea and flushing, and more frequent PRRT compared to CS- (for all, P < 0.05). Central systolic, central mean, and central end-systolic blood pressures were significantly higher in CS+ than in CS- (for all, P < 0.05). Subjects with grades 2-4 TR had higher hepatic tumour burden, fP-CgA, and S-5-HIAA compared to those with grades 0-1 TR, but measures of vascular function did not differ. fP-CgA (P = 0.017) and S-5-HIAA (P = 0.019) but not proBNP increased significantly according to the severity of TR. Conclusion Although CS is common, the prevalence of CHD was found to be lower in a contemporary cohort of SI-NET patients than previously anticipated. Measures of arterial or endothelial function or carotid atherosclerosis do not identify subjects with mild TR. Echocardiography remains the most sensitive means to diagnose CHD in CS patients with high tumour burden and elevated CgA and 5-HIAA.
Subject: Arterial function
Carcinoid heart disease
Carcinoid syndrome
Small intestinal neuroendocrine tumour
Transthoracic echocardiography
VALVE DISEASE
SEROTONIN
PROGRESSION
5-HYDROXYTRYPTAMINE
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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