Characteristics of cardiac myxoma with constitutional signs: A multicenter study in Japan

Abstract

Background: A relationship between constitutional signs in patients with cardiac myxoma and interleukin‐6 has been Noted. However, there is little information about characteristics of cardiac myxomas associated with constitutional signs. Hypothesis: The objective of this study was to clarify the characteristics of myxoma patients who had constitutional signs. Methods: Questionnaires were sent to cardiology or cardiovascular surgery divisions at university hospitals throughout Japan. Constitutional signs were considered present when a patient had fever, weight loss, or elevations of C‐reactive protein or gammaglobulin. In addition, interleukin‐6 concentrations were evaluated in some patients. Results: Data were obtained in 249 patients with primary cardiac tumors (204 myxomas, 15 other primary benign tumors, and 30 primary malignant tumors), confirmed histologically between 1993 and 1996. Fever and weight loss were observed in 15 and 6% of patients with myxoma, respectively, while C‐reactive protein and gammaglobulin were increased in 39 and 21%, respectively. This amounted to a prevalence of constitutional signs in 49%. All constitutional signs disappeared after tumor resection. Age, gender, tumor site, and frequency of thrombosis did Not differ between patients with and without constitutional signs. Tumors associated with constitutional signs were significantly more likely to be large, multiple, or recurrent than those unassociated with constitutional signs. Conclusions: Constitutional signs are present in about half of patients with myxoma. Large or multicentric tumors are likely to induce constitutional signs, which are reversible upon resection. These might suggest that constitutional signs result when interleukin‐6 concentrations exceed a certain threshold.

Clinical profile of cardiac myxoma: 11 years’ experience of 90 cases

“…The first successful surgical resection of a cardiac myxoma was performed with a cardiopulmonary bypass in 1954. 14,15 In concurrence with our series, patients with cardiac myxomas are reported to have a wide age range (17-76 years), with a mean age of approximately 45 years. There appears to be a slight female predominance, with a female-to-male ratio of 5:4.…”

Factors affecting in-hospital mortality and likelihood of undergoing surgical resection in patients with primary cardiac tumors

“…Previous studies with relatively large sample sizes (n = 124-323) reported that 82-94% of cardiac tumors were benign and 6-18% were malignant [6,7,11,15], which were consistent with the present study. The proportion of myxomas among primary cardiac tumors was 78-89% in the present study and previous Japanese studies [7,15] compared with 42-50% in previous American studies [6,11].…”

“…The proportion of myxomas among primary cardiac tumors was 78-89% in the present study and previous Japanese studies [7,15] compared with 42-50% in previous American studies [6,11]. This difference may be attributable to racial differences between American and Japanese patients.…”

“…When a cardiac tumor is highly suspected, surgical resection is the mainstay of treatment for both benign and malignant cardiac tumors [1,2,[7][8][9][10]. Most benign cardiac tumors are curable with complete resection [2,8,10,13], while malignant cardiac tumors are less likely to be completely resected and recur more frequently than benign tumors even after complete resection [20][21][22][23][24]27].…”

The Challenge Presented by Right Atrial Myxoma

“…These signs are more frequent for patients with large, multiple, or recurrent tumors [25], and are for the most part reversible upon resection [12,25,34,76]. The results of lab- oratory investigations may therefore sometimes mimic those for rheumatic or autoimmune disease [34].…”