Anorexigen-induced cardiac valvulopathy and female gender.
Obesity is a chronic disorder that is associated with significant co-morbidity and early mortality. Since the 1970s, amphetamines and amphetamine analogs have been trialed for weight loss. In 1997, the anorexigen agents, fenfluramine (Pondimin; AH Robins, Richmond, VA) and dexfenfluramine (Redux; Wyeth-Ayerst, Philadelphia, PA) gained worldwide attention when reports of associated cardiac valvulopathy and pulmonary hypertension emerged. A landmark report from the Mayo Clinic describing valvular heart disease (VHD) among women exposed to the anorexigen agent combination phentermine-fenfluramine ignited widespread concern, and the products were voluntarily withdrawn from the market by the manufacturers. Currently, the causal relationship between anorexigen agent use and valvulopathy has been validated, yet the extent and complexity of this important clinical issue remains ill-defined.
Naqvi
Tasneem Z
TZ
Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. tasneem.naqvi@cshs.org
Gross
Stacey B
SB
D000328:Adult; D001067:Appetite Depressants / Q000009:adverse effects* / Q000627:therapeutic use; D020372:Dexfenfluramine / Q000009:adverse effects / Q000627:therapeutic use; D004452:Echocardiography; D005260:Female; D005277:Fenfluramine / Q000009:adverse effects / Q000627:therapeutic use; D006349:Heart Valve Diseases / Q000139:chemically induced* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy; D010645:Phentermine / Q000009:adverse effects / Q000627:therapeutic use; D017366:Serotonin Receptor Agonists / Q000009:adverse effects / Q000627:therapeutic use
D001067:Appetite Depressants; D017366:Serotonin Receptor Agonists; D005277:Fenfluramine; D010645:Phentermine; D020372:Dexfenfluramine