{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:18:54Z","timestamp":1790709534786,"version":"4.1.0"},"reference-count":0,"publisher":"Bioscientifica","issue":"12","license":[{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/deed.en_GB"}],"content-domain":{"domain":["ec.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>Carcinoid heart disease (CHD) is a consequence of valvular fibrosis triggered by vasoactive substances released from neuroendocrine tumours, classically in those with metastatic disease and resulting in tricuspid and pulmonary valve failure. CHD affects one in five patients who have carcinoid syndrome (CS). Valve leaflets become thickened, retracted and immobile, resulting most often in regurgitation that causes right ventricular dilatation and ultimately, right heart failure. The development of CHD heralds a significantly worse prognosis than those patients with CS who do not develop valvular disease. Diagnosis requires a low threshold of suspicion in all patients with CS, since symptoms occur late in the disease process and clinical signs are difficult to elicit. As a result, routine screening is recommended using the biomarker, N-terminal pro-natriuretic peptide, and regular echocardiography is then required for diagnosis and follow-up. There is no direct medical therapy for CHD, but the focus of non-surgical care is to control CS symptoms, reduce tumour load and decrease hormone levels. Valve surgery improves long-term outcome for those with severe disease compared to medical management, although peri-operative mortality remains at between 10 and 20% in experienced centres. Therefore, care needs to be multidisciplinary at all stages, with clear discussion with the patient and between teams to ensure optimum outcome for these often-complex patients.<\/jats:p>","DOI":"10.1530\/ec-19-0413","type":"journal-article","created":{"date-parts":[[2019,11,19]],"date-time":"2019-11-19T09:28:16Z","timestamp":1574155696000},"page":"R184-R199","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":34,"title":["Multidisciplinary team management of carcinoid heart disease"],"prefix":"10.1530","volume":"8","author":[{"given":"Richard P","family":"Steeds","sequence":"first","affiliation":[{"name":"1Department of Cardiology, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK"},{"name":"2Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, 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and Intensive Care, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raheel","family":"Ahmad","sequence":"additional","affiliation":[{"name":"1Department of Cardiology, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Bradley","sequence":"additional","affiliation":[{"name":"5Therapy Services (Dietetics), University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Moore","sequence":"additional","affiliation":[{"name":"4Departments of Anaesthesia and Intensive Care, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, 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Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK"},{"name":"9Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hema","family":"Venkataraman","sequence":"additional","affiliation":[{"name":"8Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Ayuk","sequence":"additional","affiliation":[{"name":"8Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Rooney","sequence":"additional","affiliation":[{"name":"7Department of Cardiothoracic Surgery, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahir","family":"Shah","sequence":"additional","affiliation":[{"name":"6Birmingham Neuroendocrine Tumour Centre, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK"},{"name":"10Department of Hepatology and Liver Transplantation, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","container-title":["Endocrine Connections"],"original-title":[],"link":[{"URL":"https:\/\/ec.bioscientifica.com\/view\/journals\/ec\/8\/12\/EC-19-0413.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ec.bioscientifica.com\/downloadpdf\/journals\/ec\/8\/12\/EC-19-0413.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:43:45Z","timestamp":1784555025000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/ec\/article\/8\/12\/R184-R199\/615"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":0,"journal-issue":{"issue":"12"},"URL":"https:\/\/doi.org\/10.1530\/ec-19-0413","relation":{},"ISSN":["2049-3614"],"issn-type":[{"value":"2049-3614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12]]}}}