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[Fenfluramines and cardiac valvular lesions]
M Ewalenko1, C Richard, J L Vandenbossche
1Service de Cardiologie, C.H.U. Saint-Pierre, U.L.B.
Revue Medicale De Bruxelles
|December 3, 1999
Summary
Prolonged use of anorectic drugs fenfluramine (Fen) and dexfenfluramine (D-Fen) is linked to valvular heart disease. Stopping these drugs may stabilize cardiac symptoms, but long-term echocardiography monitoring is essential.
Area of Science:
- Cardiology
- Pharmacology
- Nephrology
Background:
- Anorectic drugs containing fenfluramine (Fen) and dexfenfluramine (D-Fen) have been associated with cardiac valvulopathy.
- Previous case reports suggested a link between these drugs and valvular regurgitation.
Observation:
- Fourteen female patients (42-73 years) with prolonged Fen/D-Fen intake were monitored via Doppler echocardiography.
- Seven patients also developed renal failure, attributed to co-administered Chinese herbs.
- Cardiac murmurs, dyspnea, and palpitations were common presenting symptoms.
Findings:
- A confirmed association between Fen/D-Fen and valvular heart disease was observed in the patient cohort.
- Nephrotoxicity was identified as a separate issue linked to specific Chinese herbal ingredients.
- Cardiac symptoms showed potential for stabilization or slow improvement after drug cessation and therapy initiation.
Implications:
- Long-term echocardiographic surveillance is crucial for patients with a history of Fen/D-Fen use.
- Systematic screening for cardiac and renal issues is recommended for at-risk populations.
- Endocardial prophylaxis should be considered for patients exposed to these anorectic agents.
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