There are no specific treatments for carcinoid heart disease. The noncardiac symptoms may be controlled with soma-tostatin, but the action of this drug is only minutes. Octreotide has been shown to be much more effective in reducing flushing diarrhea and urinary levels of 5-HIAA.
IV. CLINICAL STUDY
Moller et al. studied the poorly understood factors associated with the progression of carcinoid heart disease. They studied 71 patients who underwent serial echocar-diographic studies performed more than one year apart and 32 patients referred directly for surgical intervention. These workers concluded that high serotonin levels are related to the progression of carcinoid heart disease, and the risk of progressive heart disease is higher in patients who receive chemotherapy.
Somatostatin is a potent inhibitor of many processes including serotonin. In this nonrandomized study it appears that somatostatin was ineffective in prevent¬ing development of carcinoid heart disease. Findings suggested that although serotonin is related to develop¬ment of carcinoid disease, neither somatostatin therapy nor hepatic dearterialization prevents the progression of chronic lesions. Patients in the study who received cytotoxic chemotherapy had the highest risk of progressive carcinoid heart disease. The exact mechanism involved in the progression of carcinoid disease requires further clarification.