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Circulating plasma and platelet 5-hydroxytryptamine in carcinoid heart disease: a pilot study.

AbstractBACKGROUND AND AIM OF THE STUDY:
Carcinoid heart disease (CaHD) is a rare form of valvular heart disease in patients with carcinoid syndrome (CS). The role of 5-hydroxytryptamine (5-HT) in the pathogenesis of CaHD is unclear. The study aim was to evaluate the association between platelet 5-HT (5-HTplt) and plasma 5-HT (5-HTpls) and valvular dysfunction.
METHODS:
Twelve patients with CaHD, 18 with CS and 10 'normal' subjects were recruited. Patients with CaHD underwent cardiac catheterization and echocardiography. 5-HTplt and 5-HTpls was sampled in blood from the femoral vein, right and left ventricle, and left antecubital fossa vein.
RESULTS:
Levels of 5-HTpls and 5-HTplt were significantly higher in patients with CaHD (median 5-HTpls 325 nmol/l and 5-HTplt 18.9 nmol/10(9) platelets) and CS (median 5-HTpls 155 nmol/l and 5-HTplt 16.4 nmol/10(9) platelets) when compared to healthy controls (median 5-HTpls 9 nmol/l and 5-HTplt 3.7 nmol/10(9) platelets; p < 0.0001 and p = 0.003, respectively). There was a significant increase in 5-HTplt and 5-HTpls between the femoral vein and right heart (p = 0.007 and p = 0.0002, respectively). There was no significant difference in 5-HTplt or 5-HTpls between the right and left side of the heart, irrespective of the presence of a patent foramen ovale or of left-sided CaHD.
CONCLUSION:
Plasma and platelet 5-HT levels are elevated in patients with CaHD. Despite exposure to similar levels of intracardiac plasma and platelet 5-HT, the development of valve dysfunction is heterogeneous. This suggests that individual heart valves have a susceptibility to the development of valvular dysfunction which is not related solely to plasma or platelet 5-HT levels.
AuthorsSanjeev Bhattacharyya, Anita Jagroop, Dorothy M Gujral, Carl Hayward, Christos Toumpanakis, Martyn Caplin, Dimitri P Mikhailidis, Joseph Davar
JournalThe Journal of heart valve disease (J Heart Valve Dis) Vol. 22 Issue 3 Pg. 400-7 (May 2013) ISSN: 0966-8519 [Print] England
PMID24151767 (Publication Type: Journal Article)
Chemical References
  • Serotonin
Topics
  • Aged
  • Blood Platelets (metabolism)
  • Blood Specimen Collection (methods)
  • Carcinoid Heart Disease (blood, diagnosis, physiopathology)
  • Cardiac Catheterization (methods)
  • Echocardiography (methods)
  • Female
  • Heart Valve Diseases (blood, diagnosis, physiopathology)
  • Heart Valves (diagnostic imaging, physiopathology)
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Serotonin (blood, metabolism)
  • Statistics as Topic

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