Database : MEDLINE
Search on : carcinoid and heart and disease [Words]
References found : 771 [refine]
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[PMID]: 29509220
[Au] Autor:Antit S; Zakhama L; Chenik S; Saadi M; Houmed A; Mohamed S; Boussabeh E; Thameur M; Ben Youssef S
[Ti] Title:Valvular unvolvement in carcinoid disease. a case report.
[So] Source:Tunis Med;95(5):370-374, 2017 May.
[Is] ISSN:0041-4131
[Cp] Country of publication:Tunisia
[La] Language:eng
[Ab] Abstract:Carcinoid tumors are rare, mainly located in the gastrointestinal tract particularly in the small intestine. Cardiac involvement, fairly frequent and usually affecting right sided heart valves, had a poor prognosis that is improved by an earlier detection and valve surgery. We report the case of a 50-years old woman with neuroendocrine tumor and liver metastases, in whom carcinoid involvement of the right heart was diagnosed following exertional dyspnea. She had dilated right cavities, severe tricuspid regurgitation, mild tricuspid stenosis and a moderate pulmonary stenosis. She underwent a double valve replacement by bioprosthesis with improvement of symptoms and recovery of normal right cavities size.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:In-Data-Review

  2 / 771 MEDLINE  
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[PMID]: 29485963
[Au] Autor:Mujtaba SS; Clark S
[Ad] Address:Department of Cardiothoracic Surgery, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
[Ti] Title:Carcinoid Heart Disease: Early Outcomes after Surgical Valve Replacement in Nine Patients.
[So] Source:Heart Surg Forum;21(1):E040-E043, 2018 02 16.
[Is] ISSN:1522-6662
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:AIM: To describe the early outcomes of carcinoid patients undergoing surgical heart valve replacement. METHODS: In a retrospective study, records of patients with symptomatic carcinoid heart disease referred for valve surgery between 2012 and 2016 were reviewed. The perioperative and early postoperative outcomes were analyzed. RESULTS: Nine patients, with a mean age of 61 years (range 55-70 years) underwent cardiac surgery for carcinoid syndrome. 3 patients had quadruple valve replacement, 5 had tricuspid and pulmonary valves changed, while one had tricuspid, pulmonary, and aortic valves replaced. Right-sided valves were replaced with biological valves in 8 patients and a mechanical valve in 1 patient. Left-sided valves were replaced with a mechanical valve in 2 patients and with a biological valve in 1 patient. Mean postoperative follow-up was 24 months (range 6-50 months, median 16 months). All patients had a good left ventricle except one, in whom it was mildly impaired. The right ventricle was severely dilated in 4 patients, moderately in 2, and mildly in 3. One patient died of heart failure 10 days postoperatively. Functional improvement was noted in all survivors, and they were in New York Heart Association class I at last follow up. CONCLUSION: Although carcinoid syndrome is a rare and progressive disease, valve replacement in symptomatic patients is a reasonable option with survival benefit, low early postoperative mortality, without valve-related complications, and with functional improvement. Cardiac assessment is required in all patients with carcinoid disease from the earliest time of medical treatment to improve patients' result.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:In-Process
[do] DOI:10.1532/hsf.1855

  3 / 771 MEDLINE  
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[PMID]: 29420361
[Au] Autor:Preda VA; Chitoni M; Talbot D; Reed N; Grossman AB
[Ti] Title:Primary Ovarian Carcinoid: Extensive Clinical Experience With an Underrecognized Uncommon Entity.
[So] Source:Int J Gynecol Cancer;28(3):466-471, 2018 Mar.
[Is] ISSN:1525-1438
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: Primary ovarian neuroendocrine tumors (NETs) develop in pure form or in association with other tumors, mainly teratomas. The available data regarding this rare condition are limited. Much of the literature focuses on single case reports, previously dismissed as a totally benign disorder, and thus long-term considerations and evidence-based management guidelines are lacking. The objective of the current study was to describe the clinical and pathologic characteristics and the effect of various therapeutic modalities on patient morbidity and mortality from 2 major centers. A secondary objective was to highlight that carcinoid syndrome may be manifest in the absence of metastatic disease. METHODS: The authors retrospectively studied a cohort of 34 consecutive patients with primary ovarian NETs who attended either the Oxford University Hospitals or Beatson Oncology Centre, Glasgow, between 1984 and 2014, and had their ovarian carcinoid data (eg, tumor growth, chemotherapy regimen) and mortality outcomes assessed. RESULTS: All patients were women, with an average age of 53 years (range, 23-87 years) at diagnosis. Of the 34 patients, 8 patients (23.5%) presented with carcinoid symptoms. Carcinoid heart disease was evident in 2 of the 34 patients (6%). All patients had a primary ovarian carcinoid tumor on histopathology, and 2 patients had bilateral ovarian carcinoids. Teratoma associations could be assessed in 29 tumors, with 20 (69%) of 29 showing a pathological association. The mean tumor size was 48 mm (range, 4-120 mm; SD, 40 mm). The mean follow-up was 4.5 years, ranging up to 17 years. The disease has been quiescent with no evidence of relapse in 22 of 34 patients; in 12 of 34 patients, it was metastatic. There were 5 patients who received treatment with somatostatin analogs or chemotherapy, whereas 8 patients (23.5%) died of disease. Metastatic disease was found up to 11 years from initial diagnosis. CONCLUSIONS: Primary ovarian NET is rare and likely underrepresented in the literature. It can no longer be simply dismissed as a generally benign entity and may present with both the carcinoid syndrome and carcinoid heart disease. It requires careful evaluation and long-term review.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180221
[Lr] Last revision date:180221
[St] Status:In-Data-Review
[do] DOI:10.1097/IGC.0000000000001215

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[PMID]: 29386066
[Au] Autor:Khay K; Arous S; Bentaoune T; Drighil A; Habbal R
[Ad] Address:Department of Cardiology, Ibn Rushd University Hospital, Casablanca, Morocco.
[Ti] Title:Carcinoid heart disease revealed by cyanosis with both right and left valvular involvement: a case report.
[So] Source:J Med Case Rep;12(1):23, 2018 Jan 31.
[Is] ISSN:1752-1947
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Carcinoid heart disease is a frequent complication of carcinoid syndrome. It is related to the release by the carcinoid tumor and/or its metastases of bioactive substances such as serotonin. It is characterized by right-sided valvular involvement and can lead to right-sided heart failure. It is a prognostic factor of carcinoid syndrome. CASE PRESENTATION: We report the case of a 53-year-old African woman with an endocrine tumor of her small intestine complicated by carcinoid heart disease, revealed by right-sided heart failure. The diagnosis was confirmed by transthoracic echocardiography, which showed a severe tricuspid regurgitation with a patent foramen ovale, and by increased serum chromogranin A and urinary 5-hydroxyindoleacetic acid. Initially she was treated with medical therapy (furosemide and injection of somatostatin). Afterwards she was proposed for surgery. The evolution of her treatment was good. CONCLUSIONS: Carcinoid syndrome is complicated in 60% of the cases of a heart disease, and is responsible for an important morbidity and mortality. The prognosis of patients with carcinoid heart disease has improved in recent years through somatostatin analogues and the cardiac surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180209
[Lr] Last revision date:180209
[St] Status:In-Process
[do] DOI:10.1186/s13256-018-1574-6

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[PMID]: 29402626
[Au] Autor:Nicoara A; Luis SA
[Ad] Address:Department of Anesthesiology, Duke University Medical Center, Durham, NC.
[Ti] Title:The Perfect Storm: Carcinoid Heart Disease and Acute Right Ventricular Failure.
[So] Source:J Cardiothorac Vasc Anesth;, 2018 Jan 04.
[Is] ISSN:1532-8422
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:EDITORIAL
[Em] Entry month:1802
[Cu] Class update date: 180206
[Lr] Last revision date:180206
[St] Status:Publisher

  6 / 771 MEDLINE  
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[PMID]: 29395828
[Au] Autor:Hollon M; Glas K; Sumler M
[Ad] Address:Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA. Electronic address: mmayo2@emory.edu.
[Ti] Title:4-Valve Heart Disease and Right Heart Failure.
[So] Source:J Cardiothorac Vasc Anesth;, 2017 Oct 13.
[Is] ISSN:1532-8422
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Carcinoid heart disease is a rare form of heart disease due to secretion of vasoactive compounds, including serotonin, from gastrointestinal tumors. This E-challenge examines the case of a patient with advanced carcinoid heart disease who presented to the operating room (OR) for a tricuspid valve replacement. Once the patient was in the OR, intraoperative transesophageal echocardiography was used to discover a patent foramen ovale and involvement of all 4 valves with regurgitant lesions. The patient underwent tricuspid valve replacement, pulmonic valve replacement, right ventricular outflow tract reconstruction, and patent foramen closure in the OR and experienced subsequent fulminant right heart failure. Mechanical circulatory support was required to separate the patient from cardiopulmonary bypass, which was first attempted with an intra-aortic balloon pump and subsequently achieved with implantation of a right ventricular assist device. Multiple reports of acute right heart failure are available in the literature; however, this case helps illustrate several important considerations for the anesthesiologist. The effects of chronic circulating vasoactive compounds on the heart valves are well documented; however, it is likely that advanced carcinoid heart disease also will trigger pre-existing myocardial dysfunction, which may be underappreciated. Identifying patients who are at high risk for intraoperative right heart failure and considering what constitutes an adequate preoperative assessment of right heart function aid in preparing for OR management. In addition, reviewing the potential options for managing these patients when the traditional therapies are inadequate, including mechanical support and extracorporeal circulation, is a useful exercise in preparation. This case also highlights the contributions of intraoperative transesophageal echocardiography in the diagnosis and management of carcinoid heart disease, the need for additional preoperative optimization of these patients, and the management and potential complications of mechanical support.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180203
[Lr] Last revision date:180203
[St] Status:Publisher

  7 / 771 MEDLINE  
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[PMID]: 29302947
[Au] Autor:Rajamannan NM
[Ad] Address:Division of Biochemistry and Molecular Biology, Mayo Clinic and Mayo Foundation, Rochester, MN, USA.
[Ti] Title:Fenfluramine-Phentermine is Associated with an Increase in Cellular Proliferation Ex Vivo and In Vitro.
[So] Source:J Heart Valve Dis;26(4):467-471, 2017 Jul.
[Is] ISSN:0966-8519
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Fenfluraminephentermine (FenPhen) has been implicated in accelerated valvular heart disease, characterized by valvular regurgitation and thickening, and resembling the histopathologic lesions found in carcinoid. The study aim was to determine whether cellular proliferation is present in FenPhen-exposed valves, by utilizing an in-vitro model to test whether FenPhen has a direct mitogenic effect on cardiac valvular cells, as compared to serotonin. METHODS: Ex-vivo valves were tested for proliferation in surgically removed FenPhen-exposed valves (n = 10) and compared to proliferation levels in normal human cardiac valves removed at autopsy (n = 10). Immunostaining for a DNA polymerase, proliferating cell nuclear antigen (PCNA), was performed and quantified using digital imaging analysis. In-vitro assays were performed for direct proliferative effects of serotonin and FenPhen (10-6, 10-7 and 10-8 M) on porcine aortic valve subendothelial cells, using a [3H]-thymidine incorporation assay. RESULTS: Ex-vivo PCNA levels in human FenPhenexposed valves were elevated compared to controls (22.8 ± 4.54 versus 1.26 ± 0.47; p <0.001). In vivo, serotonin and FenPhen markedly increased (10-fold) cell proliferation (as measured by [3H]-thymidine incorporation) in subendothelial cells in vitro (p <0.001). This proliferative response was demonstrated by PCNA staining in carcinoid heart valves and FenPhen-exposed valves. Mechanistically, plateletderived growth factor increased cell proliferation in a dose-related manner (p <0.001), the response being inhibited by a MAP kinase inhibitor (determined by monitoring p42/44 levels). CONCLUSIONS: In vitro, FenPhen acts as a powerful mitogen on subendothelial myofibroblast valve cells. Ex vivo, cellular proliferation was significantly elevated in human FenPhen-exposed cells.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180105
[Lr] Last revision date:180105
[St] Status:In-Data-Review

  8 / 771 MEDLINE  
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[PMID]: 29217649
[Au] Autor:Hammersley D; Shamsi A; Zaman MM; Berry P; Sturridge L
[Ad] Address:Hammersley D, Frimley Park Hospital, Frimley, UK.
[Ti] Title:An unusual cause of hypoxia: getting to the heart of the matter.
[So] Source:Echo Res Pract;, 2017 Dec 07.
[Is] ISSN:2055-0464
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:A 63 year old female presented to hospital with progressive exertional dyspnoea over a 6 month period. In the year preceding her admission, she reported an intercurrent history of abdominal pain, diarrhoea and weight loss. She was found to be hypoxic, the cause for which was initially unclear. A ventilation-perfusion scan identified a right-to-left shunt. Transoesophageal echocardiography (TOE) demonstrated a significant right-to-left intracardiac shunt through a patent foramen ovale (PFO); additionally severe tricuspid regurgitation was noted through a highly abnormal tricuspid valve. The findings were consistent with carcinoid heart disease with a haemodynamically significant shunt, resulting in profound systemic hypoxia. 24 hour urinary 5-Hydroxyindoleacetic acid (5-HIAA) and imaging were consistent with a terminal ileal primary carcinoid cancer with hepatic metastasis. Liver biopsy confirmed a tissue diagnosis. The patient was commenced on medical therapy for carcinoid syndrome. She subsequently passed away while undergoing anaesthetic induction for valvular surgery to treat her carcinoid heart disease and PFO.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180105
[Lr] Last revision date:180105
[St] Status:Publisher

  9 / 771 MEDLINE  
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[PMID]: 29273478
[Au] Autor:Castillo J; Silvay G; Weiner M
[Ad] Address:Department of Cardiovascular Surgery, The Mount Sinai Hospital, Mount Sinai Health System, New York, NY; Center for Carcinoid and Neuroendocrine Tumors, The Mount Sinai Hospital, Mount Sinai Health System, New York, NY. Electronic address: javier.castillo@mountsinai.org.
[Ti] Title:Anesthetic Management of Patients With Carcinoid Syndrome and Carcinoid Heart Disease: The Mount Sinai Algorithm.
[So] Source:J Cardiothorac Vasc Anesth;, 2017 Nov 20.
[Is] ISSN:1532-8422
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 171223
[Lr] Last revision date:171223
[St] Status:Publisher

  10 / 771 MEDLINE  
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[PMID]: 29141071
[Au] Autor:Roberts WC; Becker TM; Hall SA
[Ad] Address:Baylor Heart and Vascular Institute, Baylor University Medical Center at Dallas, Dallas, Texas.
[Ti] Title:Usefulness of Total 12-Lead QRS Voltage as a Clue to Diagnosis of Patients With Cardiac Sarcoidosis Severe Enough to Warrant Orthotopic Heart Transplant.
[So] Source:JAMA Cardiol;, 2017 Nov 15.
[Is] ISSN:2380-6591
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Importance: Severe heart failure caused by cardiac sarcoidosis is difficult to diagnosis without biopsy. Objective: To assess whether total electrocardiographic 12-lead QRS voltage may be a clue to diagnosis. Design, Setting, Participants: Case-series study with cases collected at Baylor University Medical Center at Dallas, Dallas, Texas, from January 13, 2005, to January 24, 2017. The clinical records of 16 patients with severe heart failure caused by cardiac sarcoidosis were studied. Examination of total 12-lead electrocardiographic QRS voltage (peak of the R wave to the nadir of either the Q or S wave, whichever was deeper) was performed prior to orthotopic heart transplant (OHT). Gross and microscopic pathologic specimens of the native hearts were studied. Main Outcomes and Measures: The primary outcome was to correlate the total 12-lead QRS voltage measurement with various morphologic features in the native diseased heart. Results: The 16-patient study group consisted of 8 men and 8 women; 12 (75%) were white and 4 (25%) were black. At the time of OHT, patient age ranged from 50 to 67 years (mean, 57 years). Cardiac sarcoidosis was diagnosed by pre-OHT biopsy results in 2 (13%) patients and by examination of the native heart after OHT in 14 (87%) patients. Total nonpaced 12-lead QRS voltage mean was 117 mm (range, 52-155 mm) for 8 patients and total paced 12-lead QRS voltage was 90 mm (range, 67-161 mm) for 12 patients. These low mean values were similar to those of patients with carcinoid heart disease (mean [SD], 105 [40] mm), cardiac amyloidosis (104 [35] mm), and severe cardiac adiposity (120 [31] mm) studied at necropsy or after OHT. In contrast, mean (SD) values were 323 (109) mm in patients with massive cardiomegaly, 257 mm in patients with severe aortic stenosis, 272 (86) mm in patients with severe pure aortic regurgitation, 220 (67) mm in patients with severe pure mitral regurgitation, 197 (64) mm in patients with hypertrophic cardiomyopathy, and 153 (40) mm in patients with idiopathic dilated cardiomyopathy. Conclusions and Relevance: Most patients diagnosed with cardiac sarcoidosis causing severe heart failure and warranting OHT had low total 12-lead QRS voltage measurements despite having native hearts of increased weight. This finding may provide a clue to the diagnosis of this disease.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171115
[Lr] Last revision date:171115
[St] Status:Publisher
[do] DOI:10.1001/jamacardio.2017.4172


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