Seghatol Frank F, Rigolin Vera H
Department of Medicine, Division of Cardiology, Northwestern University Medical School, Chicago, Illinois 60611, USA.
Curr Opin Cardiol. 2002 Sep;17(5):486-92. doi: 10.1097/00001573-200209000-00007.
Appetite suppressants fenfluramine, dexfenfluramine, and phentermine have been used alone or in combination as an alternative to diet and surgery in the management of obesity. This therapy was halted in 1997 after reports of valvular lesions affecting almost one third of patients treated with these drugs. Fortunately, most cases of appetite suppressant-related valve disease are mild or moderate and rarely required valve repair or replacement. Follow-up studies have suggested improvement in valvulopathy after discontinuation of the treatment. The mechanism of valve disease induced by these drugs is speculative and may be related to their serotonergic effects. Echocardiographic features are similar to carcinoid heart disease and valvulopathy associated with ergot use. Most cases require only follow-up and endocarditis prophylaxis; surgery is rarely needed.
食欲抑制剂芬氟拉明、右芬氟拉明和苯丁胺已单独或联合使用，作为肥胖管理中饮食和手术的替代方法。1997年，在有报道称几乎三分之一接受这些药物治疗的患者出现瓣膜病变后，这种疗法被停止。幸运的是，大多数与食欲抑制剂相关的瓣膜病病例为轻度或中度，很少需要瓣膜修复或置换。随访研究表明，停止治疗后瓣膜病变有所改善。这些药物引起瓣膜病的机制尚属推测，可能与其血清素能效应有关。超声心动图特征与类癌性心脏病和与使用麦角相关的瓣膜病相似。大多数病例仅需随访和预防心内膜炎；很少需要手术。
