The Thickened Valve

Q: What are the key findings of this study?

Carcinoid heart disease deposits fibrous plaques on valve surfaces, affecting the tricuspid valve in 90% of patients and left-sided valves in <10% without destroying underlying valve architecture.

Q: What is the clinical evidence from this study?

Study design: Editorial. Population: Valvular heart disease (carcinoid heart disease, rheumatic heart disease, and myxomatous degeneration).

Q: What does this research mean for the field?

Carcinoid heart disease deposits fibrous plaques on valve surfaces, affecting the tricuspid valve in 90% of patients and left-sided valves in <10% without destroying underlying valve architecture. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Navneet Narula; Navneet Narula; Nupoor Narula; Nupoor Narula; Edgar Argulian

doi:10.1016/j.jaccas.2020.09.010

October 1, 2020JACC Case ReportsOpen Access

The Thickened Valve

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Key result

Carcinoid heart disease targets the tricuspid valve in ~90% of cases, depositing plaques without architecture destruction.

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Graphical abstract published by JACC Case Reports — Graphical abstract · Published by JACC Case Reports · CC BY-NC-ND

Key Points

To review the pathological mechanisms and echocardiographic features that distinguish carcinoid- and drug-induced valvular heart disease from rheumatic heart disease and myxomatous degeneration.
Clinical case evaluation and commentary analyzing a 73-year-old woman presenting with biventricular valvular disease during citalopram therapy following treated metastatic carcinoid tumor.
Comparative histological and echocardiographic analysis of structural valve alterations across carcinoid heart disease, post-inflammatory rheumatic disease, and myxomatous degeneration.
Carcinoid heart disease involves fibrous plaque deposition onto intact valve architecture; the tricuspid valve is involved in 90% of established cases, right-sided valves represent 92% of surgically excised valves, and left-sided valve involvement occurs in <10% of cases.
Rheumatic heart disease disrupts intrinsic valve architecture through chronic inflammation, neovascularization, calcification, and commissural fusion, producing characteristic leaflet doming and a 'fish mouth' orifice.
Myxomatous degeneration causes leaflet thickening and prolapse via glycosaminoglycan accumulation in the spongiosa and attenuation of the fibrosa layer without commissural fusion.

PICO

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Population

Valvular heart disease (carcinoid heart disease, rheumatic heart disease, and myxomatous degeneration)

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Implication

Distinguishes carcinoid plaques from rheumatic or myxomatous destruction on imaging; leaves open whether features guide therapy in mixed valvular disease.

Abstract

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Cite This Study

Narula et al. (2020) conducted an editorial in Valvular heart disease (carcinoid heart disease, rheumatic heart disease, and myxomatous degeneration). Carcinoid heart disease deposits fibrous plaques on valve surfaces, affecting the tricuspid valve in 90% of patients and left-sided valves in <10% without destroying underlying valve architecture.

synapsesocial.com/papers/6a93304a9a8e8168d03b731f https://doi.org/10.1016/j.jaccas.2020.09.010

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The Thickened Valve

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Key Points

PICO

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Implication

Abstract

Discussion

Cite This Study

The Thickened Valve

Figures

Key Points

PICO

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Implication

Abstract

Discussion

Cite This Study

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