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Carcinoid heart disease. Correlation of high serotonin levels with valvular abnormalities detected by cardiac catheterization and echocardiography.

Publication ,  Journal Article
Robiolio, PA; Rigolin, VH; Wilson, JS; Harrison, JK; Sanders, LL; Bashore, TM; Feldman, JM
Published in: Circulation
August 15, 1995

BACKGROUND: Although serotonin has been postulated as an etiologic agent in the development of carcinoid heart disease, no direct evidence for different ambient serotonin levels in cardiac and noncardiac patients has been reported to date. METHODS AND RESULTS: The present study reviews our experience with 604 patients in the Duke Carcinoid Database. Nineteen patients with proven carcinoid heart disease (by cardiac catheterization and/or echocardiogram) were compared with the remaining 585 noncardiac patients in the database with regard to circulating serotonin and its principal metabolite, 5-hydroxyindole acetic acid (5-HIAA). No significant demographic differences existed between the cardiac and noncardiac groups; however, typical carcinoid syndrome symptoms (ie, flushing and diarrhea) were almost threefold more common in the cardiac group (P < .001). Compared with the noncardiac group, heart disease patients demonstrated strikingly higher (P < .0001) mean serum serotonin (9750 versus 4350 pmol/mL), plasma serotonin (1130 versus 426 pmol/mL), platelet serotonin (6240 versus 2700 pmol/mg protein), and urine 5-HIAA (219 versus 55.3 mg/24 h) levels. The spectrum of heart disease among the 19 patients showed a strong right-sided valvular predominance, with tricuspid regurgitation being the most common valvular dysfunction (92% by cardiac catheterization; 100% by echocardiogram). CONCLUSIONS: These data suggest that serotonin plays a major role in the pathogenesis of the cardiac plaque formation observed in carcinoid patients.

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Published In

Circulation

DOI

ISSN

0009-7322

Publication Date

August 15, 1995

Volume

92

Issue

4

Start / End Page

790 / 795

Location

United States

Related Subject Headings

  • Survival Analysis
  • Serotonin
  • Prospective Studies
  • Male
  • Humans
  • Heart Valve Diseases
  • Heart Failure
  • Female
  • Echocardiography
  • Coronary Disease
 

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Robiolio, P. A., Rigolin, V. H., Wilson, J. S., Harrison, J. K., Sanders, L. L., Bashore, T. M., & Feldman, J. M. (1995). Carcinoid heart disease. Correlation of high serotonin levels with valvular abnormalities detected by cardiac catheterization and echocardiography. Circulation, 92(4), 790–795. https://doi.org/10.1161/01.cir.92.4.790
Robiolio, P. A., V. H. Rigolin, J. S. Wilson, J. K. Harrison, L. L. Sanders, T. M. Bashore, and J. M. Feldman. “Carcinoid heart disease. Correlation of high serotonin levels with valvular abnormalities detected by cardiac catheterization and echocardiography.Circulation 92, no. 4 (August 15, 1995): 790–95. https://doi.org/10.1161/01.cir.92.4.790.
Robiolio PA, Rigolin VH, Wilson JS, Harrison JK, Sanders LL, Bashore TM, et al. Carcinoid heart disease. Correlation of high serotonin levels with valvular abnormalities detected by cardiac catheterization and echocardiography. Circulation. 1995 Aug 15;92(4):790–5.
Robiolio, P. A., et al. “Carcinoid heart disease. Correlation of high serotonin levels with valvular abnormalities detected by cardiac catheterization and echocardiography.Circulation, vol. 92, no. 4, Aug. 1995, pp. 790–95. Pubmed, doi:10.1161/01.cir.92.4.790.
Robiolio PA, Rigolin VH, Wilson JS, Harrison JK, Sanders LL, Bashore TM, Feldman JM. Carcinoid heart disease. Correlation of high serotonin levels with valvular abnormalities detected by cardiac catheterization and echocardiography. Circulation. 1995 Aug 15;92(4):790–795.

Published In

Circulation

DOI

ISSN

0009-7322

Publication Date

August 15, 1995

Volume

92

Issue

4

Start / End Page

790 / 795

Location

United States

Related Subject Headings

  • Survival Analysis
  • Serotonin
  • Prospective Studies
  • Male
  • Humans
  • Heart Valve Diseases
  • Heart Failure
  • Female
  • Echocardiography
  • Coronary Disease