The association of a panel of biomarkers with the presence and severity of carcinoid heart disease: a cross-sectional study

Metastatic neuroendocrine tumors secrete serotonin and other vasoactive substances that are responsible for carcinoid syndrome and carcinoid heart disease. We sought to evaluate the discriminatory utility of diagnostic biomarkers in determining the presence and severity of carcinoid heart disease in...

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Bibliographic Details
Published in:PloS one 2013-09, Vol.8 (9), p.e73679-e73679
Main Authors: Dobson, Rebecca, Burgess, Malcolm I, Banks, Melissa, Pritchard, D Mark, Vora, Jiten, Valle, Juan W, Wong, Christopher, Chadwick, Carrie, George, Keith, Keevil, Brian, Adaway, Joanne, Ardill, Joy E S, Anthoney, Alan, Hofmann, Uschi, Poston, Graeme J, Cuthbertson, Daniel J
Format: Article
Language:English
Subjects:
Aged
Biological markers
Biomarkers
Biomarkers - blood
Brain
Brain natriuretic peptide
Cancer metastasis
Carcinoid Heart Disease - blood
Cardiac patients
Cardiology
Cardiovascular disease
Chronic illnesses
Confidence intervals
Coronary artery disease
Correlation
Cross-Sectional Studies
Diagnostic systems
Echocardiography
Endocrinology
Female
Heart
Heart diseases
Hospitals
Humans
Hydroxyindoleacetic Acid - blood
Liver
Male
Medical diagnosis
Medical research
Metastases
Metastasis
Middle Aged
Natriuretic peptides
Neuroendocrine tumors
Neurokinin
Neurokinin A
Neurokinin A - blood
Oncology
Pancreas
Patients
Peptides
Serotonin
Studies
Tumors
Vasoactive agents
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Summary:Metastatic neuroendocrine tumors secrete serotonin and other vasoactive substances that are responsible for carcinoid syndrome and carcinoid heart disease. We sought to evaluate the discriminatory utility of diagnostic biomarkers in determining the presence and severity of carcinoid heart disease in patients with metastatic neuroendocrine tumors. A cross-sectional study of patients with neuroendocrine tumors with documented liver metastases and/or carcinoid syndrome between April 2009-October 2012 in 5 tertiary referral centers. Serum was analyzed for Chromogranin A, Chromogranin B and N-terminal pro Brain Natriuretic Peptide (NT-proBNP). Plasma was analyzed for Neurokinin A and 5-Hydroxyindoleacetic acid (5HIAA). Echocardiography was used to determine the presence and severity of carcinoid heart disease. Non-parametric receiver operating characteristic curves were constructed for biomarkers, and the area under the curve determined. The severity of cardiac involvement was correlated with the concentration of each biomarker. A total of 187 patients were identified of whom 37 (20%) had carcinoid heart disease. Significantly higher median values of all biomarkers were found in the patients with cardiac involvement. NT-proBNP and plasma 5HIAA had the highest areas under the curve for the prediction of carcinoid heart disease [NT-proBNP 0.82 (95% confidence interval 0.74-0.90, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0073679