Bernheim Alain M, Connolly Heidi M, Hobday Timothy J, Abel Martin D, Pellikka Patricia A
Division of Cardiovascular Diseases, Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.
Prog Cardiovasc Dis. 2007 May-Jun;49(6):439-51. doi: 10.1016/j.pcad.2006.12.002.
Carcinoid heart disease is a rare form of valvular heart disease. The management of these patients is complex, as the systemic malignant disease and the cardiac involvement have to be considered at the same time. Progress in the treatment of patients with carcinoid disease has resulted in improved symptom control and survival. Development and progression of carcinoid heart disease are associated with increased morbidity and mortality. In patients with severe cardiac involvement and well-controlled systemic disease, cardiac surgery has been recognized as the only effective treatment option. Valve replacement surgery may not only be beneficial in terms of symptom relief, but may also contribute to the improved survival observed over the past 2 decades in patients with carcinoid heart disease. Early diagnosis and early surgical treatment in appropriately selected patients may provide the best results. In this article, we review the current literature regarding the biology, diagnosis, treatment, and prognosis of carcinoid heart disease.
类癌性心脏病是一种罕见的瓣膜性心脏病。这些患者的管理很复杂,因为必须同时考虑全身性恶性疾病和心脏受累情况。类癌疾病患者治疗方面的进展已使症状控制和生存率得到改善。类癌性心脏病的发生和进展与发病率和死亡率增加相关。在心脏严重受累且全身性疾病得到良好控制的患者中,心脏手术已被公认为唯一有效的治疗选择。瓣膜置换手术不仅在缓解症状方面可能有益,而且可能有助于改善类癌性心脏病患者在过去20年中观察到的生存率。对适当选择的患者进行早期诊断和早期手术治疗可能会取得最佳效果。在本文中,我们综述了关于类癌性心脏病的生物学、诊断、治疗和预后的当前文献。