Low prevalence of valvular heart disease in 226 phentermine-fenfluramine protocol subjects prospectively followed for up to 30 months

被引:43
作者
Burger, AJ
Sherman, HB
Charlamb, MJ
Kim, J
Asinas, LA
Flickner, SR
Blackburn, GL
机构
[1] Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Div Cardiol,Noninvas Cardiol Lab, Boston, MA 02215 USA
[2] Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Ctr Study Nutr Med, Boston, MA USA
关键词
D O I
10.1016/S0735-1097(99)00321-6
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES This investigation sought to determine the effect of phentermine-fenfluramine (phen-fen) on the prevalence of valvular heart disease in 226 obese subjects enrolled in a prospective, strict weight loss, research protocol. BACKGROUND Early reports have suggested that the use of phen-fen for weight loss may be associated with increased valvular heart disease. Such reports were based on small numbers of patients, limited data on dose and duration of phen-fen therapy, and no correlation with matched controls. METHODS All subjects underwent transthoracic echocardiography for significant valvular lesions within a mean of 97 days from the manufacturer's announcement of the voluntary withdrawal of fenfluramine and dexfenfluramine. Al echocardiograms were interpreted by two independent readers. RESULTS The study population included 183 women and 43 men with a mean age of 46.9 +/- 8.9 years and mean starting body mass index of 39.8 +/- 7.7 kg/m(2). Using the Food and Drug Administration criteria, significant aortic regurgitation was detected in 15 subjects (6.6%) and mitral regurgitation in 3 subjects (1.3%). Only one patient had significant regurgitation of both aortic and mitral valves. No valves had severe regurgitation. Significant valvular disease did not correlate with the dose or duration of phen-fen therapy. Furthermore, the prevalence of valvular regurgitation is comparable to the normal offspring in the Framingham Heart Study, who are similar in age, gender, and geographical location. CONCLUSIONS Phen-fen therapy is associated with a low prevalence of significant valvular regurgitation. Valvular regurgitation in our subjects may reflect age-related degenerative changes. (J Am Coll Cardiol 1999;34:1153-8) (C) 1999 by the American College of Cardiology.
引用
收藏
页码:1153 / 1158
页数:6
相关论文
共 14 条
[1]  
Bowen R., 1997, MMWR-MORBID MORTAL W, V46, P1061
[2]   Valvular heart disease associated with fenfluramine-phentermine [J].
Connolly, HM ;
Crary, JL ;
McGoon, MD ;
Hensrud, DD ;
Edwards, BS ;
Edwards, WD ;
Schaff, HV .
NEW ENGLAND JOURNAL OF MEDICINE, 1997, 337 (09) :581-588
[3]   COLOR DOPPLER ASSESSMENT OF MITRAL REGURGITATION WITH ORTHOGONAL PLANES [J].
HELMCKE, F ;
NANDA, NC ;
HSIUNG, MC ;
SOTO, B ;
ADEY, CK ;
GOYAL, RG ;
GATEWOOD, RP .
CIRCULATION, 1987, 75 (01) :175-183
[4]   The prevalence of cardiac valvular insufficiency assessed by transthoracic echocardiography in obese patients treated with appetite-suppressant drugs [J].
Khan, MA ;
Herzog, CA ;
St Peter, JV ;
Hartley, GG ;
Madlon-Kay, R ;
Dick, CD ;
Asinger, RW ;
Vessey, JT .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (11) :713-718
[5]  
Klein A L, 1990, J Am Soc Echocardiogr, V3, P54
[6]  
LANGRETH R, 1997, WALL STREET J 0331, pB8
[7]   CARCINOID HEART-DISEASE - CLINICAL AND ECHOCARDIOGRAPHIC SPECTRUM IN 74 PATIENTS [J].
PELLIKKA, PA ;
TAJIK, AJ ;
KHANDHERIA, BK ;
SEWARD, JB ;
CALLAHAN, JA ;
PITOT, HC ;
KVOLS, LK .
CIRCULATION, 1993, 87 (04) :1188-1196
[8]   EVALUATION OF AORTIC-INSUFFICIENCY BY DOPPLER COLOR FLOW MAPPING [J].
PERRY, GJ ;
HELMCKE, F ;
NANDA, NC ;
BYARD, C ;
SOTO, B .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1987, 9 (04) :952-959
[9]   VALVE DISEASE ASSOCIATED WITH ERGOT ALKALOID USE - ECHOCARDIOGRAPHIC AND PATHOLOGICAL CORRELATIONS [J].
REDFIELD, MM ;
NICHOLSON, WJ ;
EDWARDS, WD ;
TAJIK, AJ .
ANNALS OF INTERNAL MEDICINE, 1992, 117 (01) :50-52
[10]   CARCINOID HEART-DISEASE - CORRELATION OF HIGH SEROTONIN LEVELS WITH VALVULAR ABNORMALITIES DETECTED BY CARDIAC-CATHETERIZATION AND ECHOCARDIOGRAPHY [J].
ROBIOLIO, PA ;
RIGOLIN, VH ;
WILSON, JS ;
HARRISON, JK ;
SANDERS, LL ;
BASHORE, TM ;
FELDMAN, JM .
CIRCULATION, 1995, 92 (04) :790-795