دانلود رایگان مقاله انگلیسی کارسینوئید بیماری قلبی: یک راهنما برای غربالگری و زمان سنجی مداخله جراحی - اشپرینگر 2017

Abstract

The cardiac manifestations of a neuroendocrine tumour are referred to as carcinoid heart disease (CaHD) and are associated with a poor prognosis. Surgical intervention is the only proven therapeutic option and may prolong survival and quality of life. No consensus has been reached internationally with regard to screening for CaHD and the optimal timing for surgery. Although limited evidence is available on this matter, a trend towards early surgery and subsequent reduced mortality has been observed. In this review we provide an overview of the current understanding and propose a protocol to guide cardiologists in the screening for CaHD and the timing of referral to a specialised surgical centre.

Conclusion

CaHD has a detrimental effect on prognosis in NET patients. Despite the risks associated with surgery in this population, cardiac intervention has been shown to prolong survival and to increase quality of life. Over time, a trend towards earlier intervention in asymptomatic patients with signs of CaHD has been observed, with increased survival rates and lower perioperative mortality. Although consensus with regards to timing of surgery has not been reached, routine cardiac screening including clinical assessment, biomarkers, and echocardiographic parameters may aid in determining the optimal timing of referral to a specialised centre and subsequent surgical intervention.