Cardiac magnetic resonance imaging characteristics and predictors of mortality in carcinoid heart disease

Abstract Background Carcinoid heart disease (CHD) is a rare complication of neuroendocrine tumours (NETs) causing predominantly right-sided valve disease, right ventricular (RV) dilatation and failure. Cardiac magnetic resonance imaging (CMRI) is the gold standard in assessing ventricular volume and function; but can be used to assess global longitudinal strain (GLS) as a surrogate of RV function. Data is lacking on the CMRI characteristics of patients with CHD, and little is known about RV GLS in this cohort. Purpose We aim to highlight CMRI characteristics and identify predictors of mortality in patients with CHD, particularly once stratified to a surgical vs non-surgical management. Methods We identified 96 patients with CHD from hospital records at two NET centres (Jan 2005 -Dec 2023), including those who underwent surgical valve replacement (n = 63), and those who were non-surgically managed (n = 33). Baseline demographics and clinical characteristics of the patients, including CMRI data were obtained and stratified according to surgically managed vs non-surgically managed. Independent predictors of mortality from CMRI data were obtained from univariate and multivariate analysis (adjusted for age, sex and body mass index (BMI)). Finally, we looked at long term mortality outcomes with a survival analysis stratified by surgical vs non-surgical management. Results Surgically managed patients tended to be younger (64y vs 68y) and were more frequently male (52% vs 42%). The surgical group had higher RV end-diastolic volumes (223ml vs 176ml, P