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Example sentences for: fenfluramine
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Indeed, the most recently published study (which did not suffer from measurement bias) showed a high prevalence (30%) of AR in persons taking fenfluramine or dexfenfluramine at the time of the echocardiogram, similar to the older prevalence studies [ 15 ] . Regarding the potential reversibility of valve dysfunction, great caution must be exercised in assuming any substantial reversal of valvular plaques, as recent pathological studies suggest a progressive nature to these lesions [ 33 ] . Furthermore, limited, early apparent echocardiographic improvement of acute rheumatic carditis has also been recently demonstrated [ 34 ] . The early improvement seen in this setting certainly does not preclude later progression of rheumatic valvular heart disease.
The search for studies included examination of prior meta-analyses and reviews, MEDLINE search (using the terms fenfluramine or dexfenfluramine, diet drugs, echocardiogram or echocardiographic, and valvular heart disease), and review of references of identified articles.
These findings lend strong support to the view that fenfluramine and dexfenfluramine are potent causal factors in the development of both aortic and mitral valvular heart disease.
Data provided in this study can be used to estimate the relative contribution of exposure to fenfluramines to overall incidence of echocardiographically defined, FDA-positive AR and MR. Given that approximately 2.5% of the population of the United States had used anorexic prescription drugs (mostly fenfluramine and dexfenfluramine) between 1996 and 1998 [ 30 ] , approximately 32% and 11% of all FDA-positive AR and MR respectively could be attributed to fenfluramine or dexfenfluramine use.
We first evaluated studies reporting echocardiographic prevalence of FDA-positive valvulopathy (mild or greater AR and moderate or greater MR) [ 2 ] among subjects who had taken either fenfluramine or dexfenfluramine (alone or in combination with phentermine) and in matched controls [ 7 8 9 10 11 12 13 14 ] . In most of these studies, echocardiograms were performed after the drugs had been discontinued and were read without knowledge of prior drug exposure by multiple readers (table 1).
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