Introduction: Carcinoid heart disease (CHD) affects up to 15-70% of patients with carcinoid disease. Recent ENETS guidelines recommend regular echocardiographic assessment to screen for CHD. Chromogranin A (CgA) is a peptide widely used to monitor carcinoid disease progression. Neurokinin A is a tachykinin which may be a more sensitive measure of carcinoid disease progression and prognosis. N-terminal pro Brain Naturetic Peptide is used as a screening tool for heart failure and recent results suggest utility in the diagnosis of CHD.
Aim(s): To determine the whether CgA, NKA, NTproBNP can predict the presence of carcinoid heart disease in patients with carcinoid disease.
Materials and methods: Forty patients (23 males and 17 females) with carcinoid disease and either liver metastasis or carcinoid syndrome where recruited (age 64±11yrs, 58% males). We measured serum concentrations of: NKA (pancreastatin assay - Peptide Laboratory, Belfast), NTproBNP (Roche diagnostics) and CgA (pancreastatin assay - Reference Laboratory, Hammersmith). Each patient was screened by echocardiography for the presence of CHD. A diagnosis of CHD is made if there was typical thickening and shortening of the tricuspid or pulmonary valves resulting in regurgitation and/or stenosis. Scans were performed and analysed by a single operator. Receiver-operator characteristic plot analysis was used to determine the sensitivity and specificity of each of the biomarkers for the diagnosis of CHD.
Conference: 7th Annual ENETS Conference (2010)
Presenting Author: Dr Christopher Wong
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