Management and outcomes of carcinoid heart disease with liver metastases of midgut neuroendocrine tumours
ObjectiveDespite recent advances in surgical and interventional techniques, knowledge on the management of carcinoid heart disease (CHD) remains limited. In a cohort of patients with liver metastases of midgut neuroendocrine tumours (NETs), we aimed to describe the perioperative management and short...
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| Veröffentlicht in: | Heart (British Cardiac Society) 2024-01, Vol.110 (2), p.132-139 |
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| creator | Suc, Gaspard Cachier, Agnès Hentic, Olivia Bazire, Baptiste Sannier, Aurélie Delhomme, Clémence Nataf, Patrick Laschet, Jamila Deschamps, Lydia Garbarz, Eric Ou, Phalla Caligiuri, Giuseppina Iung, Bernard Ruszniewski, Philippe de Mestier, Louis Arangalage, Dimitri |
| description | ObjectiveDespite recent advances in surgical and interventional techniques, knowledge on the management of carcinoid heart disease (CHD) remains limited. In a cohort of patients with liver metastases of midgut neuroendocrine tumours (NETs), we aimed to describe the perioperative management and short-term outcomes of CHD.MethodsFrom January 2003 to June 2022, consecutive patients with liver metastases of midgut NETs and severe CHD (severe valve disease with symptoms and/or right ventricular enlargement) were included at Beaujon and Bichat hospitals. All patients underwent clinical evaluation and echocardiography.ResultsOut of 43 (16%) consecutive patients with severe CHD and liver metastases of midgut NETs, 79% presented with right-sided heart failure. Tricuspid valve replacement was performed in 26 (53%) patients including 19 (73%) cases of combined pulmonary valve replacement. The 30-day postoperative mortality rate was high (19%), and preoperative heart failure was associated with worse survival (p=0.02). Epicardial pacemakers were systematically implanted in operated patients and 25% were permanently paced. A postoperative positive right ventricular remodelling was observed (p |
| doi_str_mv | 10.1136/heartjnl-2023-322945 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2839739546</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2839739546</sourcerecordid><originalsourceid>FETCH-LOGICAL-b404t-325a93637645279e6008d163ae458b22dfba5a3ab1c95559176310a786c7012a3</originalsourceid><addsrcrecordid>eNp9kU1rFTEYhYMotl79ByIBN25G8_2xlFJroeJGwV3IzLy3zWWS1CSj9N-bdloFF4VAQnjOeU9yEHpNyXtKufpwBb60Q1oGRhgfOGNWyCfomApl-hX98bSfuZSDIlwfoRe1Hgghwhr1HB1xLRTXnB2j8MUnfwkRUsM-zTivbcoRKs57PPkyhZTDjO9m4TlU8BXw79Cu8BJ-QcERmq99bYIY5su14QRryZDmPJWQALc15rXUl-jZ3i8VXt3vO_T90-m3k8_Dxdez85OPF8MoiGj9IdJb3tMpIZm2oAgxM1Xcg5BmZGzej1567kc6WSmlpVpxSrw2atKEMs936N3me13yzxVqczHUCZbFJ8hrdcxwq7mV_Qd26O1_6KEnTT2dY1ZqQ3si8ShluNFC9qydEhs1lVxrgb27LiH6cuMocbeFuYfC3G1hbiusy97cm69jhPmv6KGhDpANGOPh3-BHPf8Axm2iOg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2838745764</pqid></control><display><type>article</type><title>Management and outcomes of carcinoid heart disease with liver metastases of midgut neuroendocrine tumours</title><source>MEDLINE</source><source>PubMed Central</source><creator>Suc, Gaspard ; Cachier, Agnès ; Hentic, Olivia ; Bazire, Baptiste ; Sannier, Aurélie ; Delhomme, Clémence ; Nataf, Patrick ; Laschet, Jamila ; Deschamps, Lydia ; Garbarz, Eric ; Ou, Phalla ; Caligiuri, Giuseppina ; Iung, Bernard ; Ruszniewski, Philippe ; de Mestier, Louis ; Arangalage, Dimitri</creator><creatorcontrib>Suc, Gaspard ; Cachier, Agnès ; Hentic, Olivia ; Bazire, Baptiste ; Sannier, Aurélie ; Delhomme, Clémence ; Nataf, Patrick ; Laschet, Jamila ; Deschamps, Lydia ; Garbarz, Eric ; Ou, Phalla ; Caligiuri, Giuseppina ; Iung, Bernard ; Ruszniewski, Philippe ; de Mestier, Louis ; Arangalage, Dimitri</creatorcontrib><description>ObjectiveDespite recent advances in surgical and interventional techniques, knowledge on the management of carcinoid heart disease (CHD) remains limited. In a cohort of patients with liver metastases of midgut neuroendocrine tumours (NETs), we aimed to describe the perioperative management and short-term outcomes of CHD.MethodsFrom January 2003 to June 2022, consecutive patients with liver metastases of midgut NETs and severe CHD (severe valve disease with symptoms and/or right ventricular enlargement) were included at Beaujon and Bichat hospitals. All patients underwent clinical evaluation and echocardiography.ResultsOut of 43 (16%) consecutive patients with severe CHD and liver metastases of midgut NETs, 79% presented with right-sided heart failure. Tricuspid valve replacement was performed in 26 (53%) patients including 19 (73%) cases of combined pulmonary valve replacement. The 30-day postoperative mortality rate was high (19%), and preoperative heart failure was associated with worse survival (p=0.02). Epicardial pacemakers were systematically implanted in operated patients and 25% were permanently paced. A postoperative positive right ventricular remodelling was observed (p<0.001). A greater myofibroblastic infiltration was observed in pulmonary versus tricuspid valves (p<0.001), suggesting that they may have been explanted at an earlier stage of the disease than the tricuspid valve, with therefore potential for evolution.ConclusionsWe observed a high postoperative mortality rate and baseline right-sided heart failure was associated with worse outcome. In surviving patients, a positive right ventricular remodelling was observed. Prospective, multicentre studies are warranted to better define the management strategy and to identify biomarkers associated with outcome in CHD.</description><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/heartjnl-2023-322945</identifier><identifier>PMID: 37463732</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd and British Cardiovascular Society</publisher><subject>Carcinoid Heart Disease - complications ; Cardiac surgery ; Cardiovascular disease ; Coronary vessels ; Ejection fraction ; Heart failure ; Heart Failure - complications ; Heart Valve Diseases ; Heart Valve Prosthesis Implantation - methods ; Humans ; Liver ; Liver Neoplasms - complications ; Metastasis ; Mortality ; Neuroendocrine tumors ; Neuroendocrine Tumors - complications ; Neuroendocrine Tumors - surgery ; Patients ; Prospective Studies ; Pulmonary arteries ; Pulmonary Valve Insufficiency ; Surgery ; Tricuspid Valve Insufficiency ; Valvular heart disease ; Vein & artery diseases ; Ventricular Remodeling</subject><ispartof>Heart (British Cardiac Society), 2024-01, Vol.110 (2), p.132-139</ispartof><rights>Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2023 Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2023 Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b404t-325a93637645279e6008d163ae458b22dfba5a3ab1c95559176310a786c7012a3</citedby><cites>FETCH-LOGICAL-b404t-325a93637645279e6008d163ae458b22dfba5a3ab1c95559176310a786c7012a3</cites><orcidid>0000-0002-0898-9090 ; 0000-0002-9127-348X ; 0000-0003-2273-1528</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37463732$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Suc, Gaspard</creatorcontrib><creatorcontrib>Cachier, Agnès</creatorcontrib><creatorcontrib>Hentic, Olivia</creatorcontrib><creatorcontrib>Bazire, Baptiste</creatorcontrib><creatorcontrib>Sannier, Aurélie</creatorcontrib><creatorcontrib>Delhomme, Clémence</creatorcontrib><creatorcontrib>Nataf, Patrick</creatorcontrib><creatorcontrib>Laschet, Jamila</creatorcontrib><creatorcontrib>Deschamps, Lydia</creatorcontrib><creatorcontrib>Garbarz, Eric</creatorcontrib><creatorcontrib>Ou, Phalla</creatorcontrib><creatorcontrib>Caligiuri, Giuseppina</creatorcontrib><creatorcontrib>Iung, Bernard</creatorcontrib><creatorcontrib>Ruszniewski, Philippe</creatorcontrib><creatorcontrib>de Mestier, Louis</creatorcontrib><creatorcontrib>Arangalage, Dimitri</creatorcontrib><title>Management and outcomes of carcinoid heart disease with liver metastases of midgut neuroendocrine tumours</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><addtitle>Heart</addtitle><description>ObjectiveDespite recent advances in surgical and interventional techniques, knowledge on the management of carcinoid heart disease (CHD) remains limited. In a cohort of patients with liver metastases of midgut neuroendocrine tumours (NETs), we aimed to describe the perioperative management and short-term outcomes of CHD.MethodsFrom January 2003 to June 2022, consecutive patients with liver metastases of midgut NETs and severe CHD (severe valve disease with symptoms and/or right ventricular enlargement) were included at Beaujon and Bichat hospitals. All patients underwent clinical evaluation and echocardiography.ResultsOut of 43 (16%) consecutive patients with severe CHD and liver metastases of midgut NETs, 79% presented with right-sided heart failure. Tricuspid valve replacement was performed in 26 (53%) patients including 19 (73%) cases of combined pulmonary valve replacement. The 30-day postoperative mortality rate was high (19%), and preoperative heart failure was associated with worse survival (p=0.02). Epicardial pacemakers were systematically implanted in operated patients and 25% were permanently paced. A postoperative positive right ventricular remodelling was observed (p<0.001). A greater myofibroblastic infiltration was observed in pulmonary versus tricuspid valves (p<0.001), suggesting that they may have been explanted at an earlier stage of the disease than the tricuspid valve, with therefore potential for evolution.ConclusionsWe observed a high postoperative mortality rate and baseline right-sided heart failure was associated with worse outcome. In surviving patients, a positive right ventricular remodelling was observed. Prospective, multicentre studies are warranted to better define the management strategy and to identify biomarkers associated with outcome in CHD.</description><subject>Carcinoid Heart Disease - complications</subject><subject>Cardiac surgery</subject><subject>Cardiovascular disease</subject><subject>Coronary vessels</subject><subject>Ejection fraction</subject><subject>Heart failure</subject><subject>Heart Failure - complications</subject><subject>Heart Valve Diseases</subject><subject>Heart Valve Prosthesis Implantation - methods</subject><subject>Humans</subject><subject>Liver</subject><subject>Liver Neoplasms - complications</subject><subject>Metastasis</subject><subject>Mortality</subject><subject>Neuroendocrine tumors</subject><subject>Neuroendocrine Tumors - complications</subject><subject>Neuroendocrine Tumors - surgery</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Pulmonary arteries</subject><subject>Pulmonary Valve Insufficiency</subject><subject>Surgery</subject><subject>Tricuspid Valve Insufficiency</subject><subject>Valvular heart disease</subject><subject>Vein & artery diseases</subject><subject>Ventricular Remodeling</subject><issn>1355-6037</issn><issn>1468-201X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kU1rFTEYhYMotl79ByIBN25G8_2xlFJroeJGwV3IzLy3zWWS1CSj9N-bdloFF4VAQnjOeU9yEHpNyXtKufpwBb60Q1oGRhgfOGNWyCfomApl-hX98bSfuZSDIlwfoRe1Hgghwhr1HB1xLRTXnB2j8MUnfwkRUsM-zTivbcoRKs57PPkyhZTDjO9m4TlU8BXw79Cu8BJ-QcERmq99bYIY5su14QRryZDmPJWQALc15rXUl-jZ3i8VXt3vO_T90-m3k8_Dxdez85OPF8MoiGj9IdJb3tMpIZm2oAgxM1Xcg5BmZGzej1567kc6WSmlpVpxSrw2atKEMs936N3me13yzxVqczHUCZbFJ8hrdcxwq7mV_Qd26O1_6KEnTT2dY1ZqQ3si8ShluNFC9qydEhs1lVxrgb27LiH6cuMocbeFuYfC3G1hbiusy97cm69jhPmv6KGhDpANGOPh3-BHPf8Axm2iOg</recordid><startdate>20240101</startdate><enddate>20240101</enddate><creator>Suc, Gaspard</creator><creator>Cachier, Agnès</creator><creator>Hentic, Olivia</creator><creator>Bazire, Baptiste</creator><creator>Sannier, Aurélie</creator><creator>Delhomme, Clémence</creator><creator>Nataf, Patrick</creator><creator>Laschet, Jamila</creator><creator>Deschamps, Lydia</creator><creator>Garbarz, Eric</creator><creator>Ou, Phalla</creator><creator>Caligiuri, Giuseppina</creator><creator>Iung, Bernard</creator><creator>Ruszniewski, Philippe</creator><creator>de Mestier, Louis</creator><creator>Arangalage, Dimitri</creator><general>BMJ Publishing Group Ltd and British Cardiovascular Society</general><general>BMJ Publishing Group LTD</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0898-9090</orcidid><orcidid>https://orcid.org/0000-0002-9127-348X</orcidid><orcidid>https://orcid.org/0000-0003-2273-1528</orcidid></search><sort><creationdate>20240101</creationdate><title>Management and outcomes of carcinoid heart disease with liver metastases of midgut neuroendocrine tumours</title><author>Suc, Gaspard ; Cachier, Agnès ; Hentic, Olivia ; Bazire, Baptiste ; Sannier, Aurélie ; Delhomme, Clémence ; Nataf, Patrick ; Laschet, Jamila ; Deschamps, Lydia ; Garbarz, Eric ; Ou, Phalla ; Caligiuri, Giuseppina ; Iung, Bernard ; Ruszniewski, Philippe ; de Mestier, Louis ; Arangalage, Dimitri</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b404t-325a93637645279e6008d163ae458b22dfba5a3ab1c95559176310a786c7012a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Carcinoid Heart Disease - complications</topic><topic>Cardiac surgery</topic><topic>Cardiovascular disease</topic><topic>Coronary vessels</topic><topic>Ejection fraction</topic><topic>Heart failure</topic><topic>Heart Failure - complications</topic><topic>Heart Valve Diseases</topic><topic>Heart Valve Prosthesis Implantation - methods</topic><topic>Humans</topic><topic>Liver</topic><topic>Liver Neoplasms - complications</topic><topic>Metastasis</topic><topic>Mortality</topic><topic>Neuroendocrine tumors</topic><topic>Neuroendocrine Tumors - complications</topic><topic>Neuroendocrine Tumors - surgery</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Pulmonary arteries</topic><topic>Pulmonary Valve Insufficiency</topic><topic>Surgery</topic><topic>Tricuspid Valve Insufficiency</topic><topic>Valvular heart disease</topic><topic>Vein & artery diseases</topic><topic>Ventricular Remodeling</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Suc, Gaspard</creatorcontrib><creatorcontrib>Cachier, Agnès</creatorcontrib><creatorcontrib>Hentic, Olivia</creatorcontrib><creatorcontrib>Bazire, Baptiste</creatorcontrib><creatorcontrib>Sannier, Aurélie</creatorcontrib><creatorcontrib>Delhomme, Clémence</creatorcontrib><creatorcontrib>Nataf, Patrick</creatorcontrib><creatorcontrib>Laschet, Jamila</creatorcontrib><creatorcontrib>Deschamps, Lydia</creatorcontrib><creatorcontrib>Garbarz, Eric</creatorcontrib><creatorcontrib>Ou, Phalla</creatorcontrib><creatorcontrib>Caligiuri, Giuseppina</creatorcontrib><creatorcontrib>Iung, Bernard</creatorcontrib><creatorcontrib>Ruszniewski, Philippe</creatorcontrib><creatorcontrib>de Mestier, Louis</creatorcontrib><creatorcontrib>Arangalage, Dimitri</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Suc, Gaspard</au><au>Cachier, Agnès</au><au>Hentic, Olivia</au><au>Bazire, Baptiste</au><au>Sannier, Aurélie</au><au>Delhomme, Clémence</au><au>Nataf, Patrick</au><au>Laschet, Jamila</au><au>Deschamps, Lydia</au><au>Garbarz, Eric</au><au>Ou, Phalla</au><au>Caligiuri, Giuseppina</au><au>Iung, Bernard</au><au>Ruszniewski, Philippe</au><au>de Mestier, Louis</au><au>Arangalage, Dimitri</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management and outcomes of carcinoid heart disease with liver metastases of midgut neuroendocrine tumours</atitle><jtitle>Heart (British Cardiac Society)</jtitle><stitle>Heart</stitle><addtitle>Heart</addtitle><date>2024-01-01</date><risdate>2024</risdate><volume>110</volume><issue>2</issue><spage>132</spage><epage>139</epage><pages>132-139</pages><issn>1355-6037</issn><eissn>1468-201X</eissn><abstract>ObjectiveDespite recent advances in surgical and interventional techniques, knowledge on the management of carcinoid heart disease (CHD) remains limited. In a cohort of patients with liver metastases of midgut neuroendocrine tumours (NETs), we aimed to describe the perioperative management and short-term outcomes of CHD.MethodsFrom January 2003 to June 2022, consecutive patients with liver metastases of midgut NETs and severe CHD (severe valve disease with symptoms and/or right ventricular enlargement) were included at Beaujon and Bichat hospitals. All patients underwent clinical evaluation and echocardiography.ResultsOut of 43 (16%) consecutive patients with severe CHD and liver metastases of midgut NETs, 79% presented with right-sided heart failure. Tricuspid valve replacement was performed in 26 (53%) patients including 19 (73%) cases of combined pulmonary valve replacement. The 30-day postoperative mortality rate was high (19%), and preoperative heart failure was associated with worse survival (p=0.02). Epicardial pacemakers were systematically implanted in operated patients and 25% were permanently paced. A postoperative positive right ventricular remodelling was observed (p<0.001). A greater myofibroblastic infiltration was observed in pulmonary versus tricuspid valves (p<0.001), suggesting that they may have been explanted at an earlier stage of the disease than the tricuspid valve, with therefore potential for evolution.ConclusionsWe observed a high postoperative mortality rate and baseline right-sided heart failure was associated with worse outcome. In surviving patients, a positive right ventricular remodelling was observed. Prospective, multicentre studies are warranted to better define the management strategy and to identify biomarkers associated with outcome in CHD.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd and British Cardiovascular Society</pub><pmid>37463732</pmid><doi>10.1136/heartjnl-2023-322945</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-0898-9090</orcidid><orcidid>https://orcid.org/0000-0002-9127-348X</orcidid><orcidid>https://orcid.org/0000-0003-2273-1528</orcidid></addata></record> |
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| language | eng |
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| subjects | Carcinoid Heart Disease - complications Cardiac surgery Cardiovascular disease Coronary vessels Ejection fraction Heart failure Heart Failure - complications Heart Valve Diseases Heart Valve Prosthesis Implantation - methods Humans Liver Liver Neoplasms - complications Metastasis Mortality Neuroendocrine tumors Neuroendocrine Tumors - complications Neuroendocrine Tumors - surgery Patients Prospective Studies Pulmonary arteries Pulmonary Valve Insufficiency Surgery Tricuspid Valve Insufficiency Valvular heart disease Vein & artery diseases Ventricular Remodeling |
| title | Management and outcomes of carcinoid heart disease with liver metastases of midgut neuroendocrine tumours |
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