Echocardiographic prevalence of mitral and/or aortic regurgitation in patients exposed to either fenfluramine-phentermine combination or to dexfenfluramine

We evaluated the prevalence of valvular regurgitation in patients who have taken anorectic medications. Two-dimensional echocardiograms with color flo w Doppler were recorded in 200 consecutive patients referred to a major met ropolitan hospital far evaluation of cardiac function because of a history of anorectic medication use. Each patient filled out a questionnaire at the time of the visit or through telephone contact. Each echocardiogram was re viewed by 2 observers. The degree of valvular regurgitation was graded by a consensus of both observers. Significant valvular regurgitation was define d as at least moderate mitral regurgitation (MR) or at least mild aortic re gurgitation (AR), as recommended by the Food and Drug Administration and Ce nters for Disease Control and Prevention. For all patients having token ano rectic dregs, there was a 5% prevalence of at least moderate MR, a 12% prev alence of at least mild AR, and a 16% prevalence of significant MR and/or A R. Patients with significant AR and/or MR were older than those without sig nificant valvular regurgitation (49 +/- 12 vs 44 +/- 11 years, p = 0.03). P atients with significant MR and/or AR had a longer exposure duration (8 vs 6 months, p = 0.049) to anorectic drugs. There was no difference in weight loss between those with and without significant regurgitation (p = NS). The 2 largest subgroups were patients who took the fenfluramine-phentermine co mbination (n = 127) and those who took dexfenfluramine alone (n = 42). The prevalence of significant MR and AR was 5% and 9% for the fenfluromine-phen termine group and 0% and 14% for the dexfenfluramine group, respectively. T here was also a high subthreshold level of MR and AR in these patients. (C) 1999 by Excerpta Medica, Inc.