(Circulation. 2000;102:e180.)
© 2000 American Heart Association, Inc.
Correspondence |
Fen/Phen and Valvular Heart Disease: The Final Link Has Now Been Established
Professor of Medicine, The George Washington University, Washington, DC 20037
To the Editor:
The findings reported by Shively et al1 that dexfenfluramine-induced valvulopathy may regress after cessation of drug use received further support from the latest report from the Mayo Clinic.2 These 2 reports are extremely important not only from the prognostic standpoint, but also from the diagnostic point of view.
Recently, published reports challenged the well-established association between dexfenfluramine use and valvular regurgitation.3 4 5 However, the reports by Shively et al1 and Hensrud et al2 should dispel any doubt, because the Koch’s postulates have now been fulfilled.
References
1.
Shively BK, Roldan CA, Gill EA, et al. Prevalence and determinants of
valvulopathy in patients treated with dexfenfluramine.
Circulation. 1999;100:2161–2167.
2. Hensrud DD, Connolly HM, Grogan M, et al. Echocardiographic improvement over time after cessation of use of fenfluramine and phentermine. Mayo Clin Proc. 1999;74:1191–1197.[Abstract]
3.
Weissman NJ, Tighe
JF Jr, Gottdiener JS, et al. An assessment of heart-valve abnormalities
in obese patients taking dexfenfluramine, sustained-release
dexfenfluramine, or placebo. N Engl
J Med. 1998;339:725–732.
4.
Burger AJ, Sherman
HB, Charlamb MJ, et al. Low prevalence of valvular heart
disease in 226 phentermine-fenfluramine protocol subjects prospectively
followed for up to 30 months. J Am
Coll Cardiol. 1999;34:1153–1158.
5.
Schiller NB.
Fen/phen and valvular heart disease: if it sounds too bad to be
true, perhaps it isn’t. J Am Coll
Cardiol. 1999;34:1159–1162.
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