Cannistra L B, Gaasch W H
Department of Cardiology, Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860, USA.
Cardiol Rev. 1999 Nov-Dec;7(6):356-61. doi: 10.1097/00045415-199911000-00014.
The popular diet drugs, fenfluramine and dexfenfluramine, were withdrawn from the market in the United States after the publication of an association of these drugs with valvulopathy in a small series of patients, spontaneous reports to the Food and Drug Administration, and echocardiographic surveys that suggested a valvulopathy prevalence of 32.8% among diet drug users. Subsequent publications suggested that there is an association of these agents with valvulopathy, but that the prevalence seems lower than initially suspected. This review examines the available prevalence data and attempts to account for some of the variability in these data. Potential pathophysiologic mechanisms are discussed and management guidelines for these patients are provided. This is an area of ongoing study and more information about the natural history of these lesions will certainly be forthcoming. A review of the data reveals that the withdrawal of these agents was prudent and likely prevented further harm.
常用的减肥药物芬氟拉明和右芬氟拉明在美国上市后被撤市，此前有一系列小型研究表明这些药物与瓣膜病有关联，有向美国食品药品监督管理局的自发报告，还有超声心动图调查显示减肥药物使用者中瓣膜病患病率为32.8%。随后的出版物表明这些药物与瓣膜病有关联，但患病率似乎低于最初的怀疑。本综述研究了现有的患病率数据，并试图解释这些数据中的一些变异性。讨论了潜在的病理生理机制，并为这些患者提供了管理指南。这是一个正在进行研究的领域，关于这些病变自然史的更多信息肯定会出现。对数据的回顾表明，撤市这些药物是谨慎的，很可能预防了进一步的危害。
