当前位置: X-MOL 学术Ann. d'Endocrinol. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Managing carcinoid heart disease in patients with neuroendocrine tumors
Annales d'Endocrinologie ( IF 3.1 ) Pub Date : 2020-12-13 , DOI: 10.1016/j.ando.2020.12.007
Apostolos Koffas 1 , Christos Toumpanakis 1
Affiliation  

Carcinoid heart disease is a complex clinical entity frequently complicating the course of neuroendocrine tumors and carcinoid syndrome and is associated with significant morbidity and mortality. Although the pathogenesis of carcinoid heart disease remains poorly understood, it appears that the exposure to excessive circulating levels of serotonin contribute a key role, triggering a cascade of events that ultimately results in the development of plaque-like material on the endocardial surfaces of the valve leaflets. The occurrence of carcinoid heart disease may initially run an asymptomatic period, followed by the development of symptoms of congestive cardiac failure. The diagnosis of carcinoid heart disease is suspected by raised biomarkers, such as serum NT-pro-BNP and confirmed by imaging modalities, with echocardiogram being the gold standard to date. Carcinoid heart disease treatment remains challenging as in addition to cardiac dysfunction, tumor burden needs to be tackled with, hence requiring a multidisciplinary approach. Therapy comprises watchful waiting during the first initial stages of the disease; medications for heart failure; optimal control of serotonin secretion from the NET with pharmacotherapy, interventional means or even surgical techniques; and, in selected patients, cardiac valve replacement. The current review summarizes the literature on the diagnosis and management of carcinoid heart disease.



中文翻译:

治疗神经内分泌肿瘤患者的类癌心脏病

类癌心脏病是一种复杂的临床实体,经常使神经内分泌肿瘤和类癌综合征的病程复杂化,并且与显着的发病率和死亡率相关。尽管类癌性心脏病的发病机制仍知之甚少,但似乎暴露于循环水平过高的血清素起到了关键作用,引发了一系列事件,最终导致瓣膜心内膜表面出现斑块样物质传单。类癌心脏病的发生最初可能是无症状期,随后出现充血性心力衰竭的症状。通过升高的生物标志物(如血清 NT-pro-BNP)怀疑类癌性心脏病的诊断,并通过影像学方法证实,超声心动图是迄今为止的黄金标准。类癌心脏病的治疗仍然具有挑战性,因为除了心脏功能障碍外,还需要解决肿瘤负担,因此需要多学科方法。治疗包括在疾病的最初阶段观察等待;治疗心力衰竭的药物;通过药物疗法、介入手段甚至手术技术对 NET 的血清素分泌进行最佳控制;并且,在选定的患者中,心脏瓣膜置换术。本综述总结了类癌性心脏病诊断和治疗的文献。治疗包括在疾病的最初阶段观察等待;治疗心力衰竭的药物;通过药物疗法、介入手段甚至手术技术对 NET 的血清素分泌进行最佳控制;并且,在选定的患者中,心脏瓣膜置换术。本综述总结了类癌性心脏病诊断和治疗的文献。治疗包括在疾病的最初阶段观察等待;治疗心力衰竭的药物;通过药物疗法、介入手段甚至手术技术对 NET 的血清素分泌进行最佳控制;并且,在选定的患者中,心脏瓣膜置换术。本综述总结了类癌性心脏病诊断和治疗的文献。

更新日期:2020-12-13
down
wechat
bug