Myocardial motion abnormalities in patients with carcinoid disease without overt carcinoid heart disease

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Introduction: Cardiac abnormalities occur in 15-70% of patients with carcinoid disease, typified by fibrosis of the right-sided valves. Myocardial motion abnormalities in subjects without overt carcinoid heart disease have not been previously described. Tissue Doppler Imaging (TDI) allows quantative analysis of myocardial motion. We used this technique to investigate whether myocardial motion is reduced, suggesting fibrosis, in patients with carcinoid disease.

Aim(s): To use TDI to identify myocardial motion abnormalities in patients with metastatic carcinoid disease.

Materials and methods: We prospectively recruited 68 patients with metastatic midgut carcinoid disease and 10 normal age matched controls. Six patients with 2D echocardiographic evidence of overt carcinoid heart disease were excluded. Subjects underwent transthoracic echocardiography using a GE Vivid 7 or Vivid Q machine (2.5MHz phased array transducer). Color tissue Doppler loops (3 cardiac cycles) in three imaging planes were acquired, triggered to the ECG, and saved digitally for subsequent off line analysis by a single experienced operator (Echopac V9.01). Regional myocardial velocity curves were derived using a 6x6mm sample volume placed in the standard six basal segments of the left ventricular wall. For the right ventricle, the basal segment in the 4-chamber view was used. Strain and strain rate curves were generated in a similar way using a 5x12 mm sample volume.

Conference: 7th Annual ENETSConcerence (2010)

Presenting Author:

Authors: Wong C, Burgess M, Banks M, Poston G, Cuthbertson D,

Keywords: carcinoid heart disease, tissue doppler imaging, carcinoid syndrome, metastatic carcinoid disease, echocardiography,