デキスフェンフルーラミンまたはフェンターミン/フェンフルーラミンに曝露した後のバルブ異常および心血管状態
J M Gardin1, D Schumacher, G Constantine
1Division of Cardiology, University of California, Irvine, USA.
JAMA
|February 7, 2001
まとめ
フェンフルラミンおよびフェンターミン/フェンフルラミンの使用は,大動脈吐 (AR) の罹患率を増加させたが,ミトラル吐 (MR) や重篤な心臓事件は発生しなかった. この研究では,これらの肥満薬に関連する心血管疾患のリスクを評価するために,治療を受けた患者と対照群を比較しました.
科学分野:
- 心臓病学 心臓病学
- 薬理学 薬理学とは
- 公衆衛生は公衆衛生である.
背景:
- フェンフルラミンとデックスフェンフルラミンは,心臓弁の異常に関する懸念のために撤回されました.
- 以前の研究では,未治療の対照群との比較が欠け,薬物に関連するリスクの理解を制限していました.
研究 の 目的:
- デキスフェンフルーラミンまたはフェンターミン/フェンフルーラミンで肥満を治療する患者の心血管状態と弁の異常を評価するために.
- アノレキシゲン治療を受けた被験者と,マッチした未治療対照群の心臓血管のパラメータとエコーカルディオグラフィの発見を比較する.
主な方法:
- 25の米国の臨床センターで実施された読者盲検の制御研究です.
- 対象となる被験者1473人 (デックスフェンフルラミン479人,フェンフルラミン455人,対照群539人) は,臨床データと心声データを提供した.
- エコーカルディオグラフィは,FDAの基準を用いて大動脈 (AR) とミトラル (MR) 排泄を評価し,弁の小葉の移動性と厚さも評価した.
主要な成果:
- 心血管疾患の徴候と症状は,治療群と未治療群の間で類似していました.
- ARの有意な増加は,デクスフェンフルラミン (8.9%) とフェンターミン/フェンフルラミン (13.7%) の両群で,対照群 (4.1%) に比べて観察されました.
- MRの罹患率,弁のパンフレットの変化,肺動脈圧,エジェクション分数,または重篤な心臓イベントの有意な違いは見つかりませんでした.
結論:
- デックスフェンフルラミンおよびフェンターミン/フェンフルラミンの使用は,FDAのエコーカルディオグラフィック基準に基づいて,大動脈吐率の増加と関連しています.
- これらのアノレキシゲンは,ミトラル回の増加や深刻な心臓イベントと関連しませんでした.
- これらの発見は,以前に処方された肥満薬に関連した特定の心血管リスク (AR) を強調しています.
関連する概念動画
01:20Exercise and Cardiovascular Response
Exercise significantly impacts cardiovascular response, which is crucial for understanding patient health and designing effective treatment plans.
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
01:29Cardiovascular System Abnormal Findings I: Inspection and Palpation
In a cardiovascular examination, inspection and palpation are crucial for identifying abnormalities.
Abnormal findings observed during an inspection
Abnormal findings observed during an inspection
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion, evaluates...
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion, evaluates...
01:20Imaging Studies for Cardiovascular System III: X-Ray
The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:30Heart Failure V: Medical Management
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
01:30Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...