{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T10:51:59Z","timestamp":1790506319198,"version":"4.1.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1999,11,23]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            \u2014Valve regurgitation has been associated with dexfenfluramine, but its prevalence and severity are uncertain. Additional factors that may contribute to valve regurgitation in patients exposed to this drug are poorly understood.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            \u2014Echocardiography was performed on subjects recruited from 26 prescribing sites in 15 states. The total sample of 412 subjects included 172 dexfenfluramine patients and 172 unexposed controls matched for age, sex, and body mass index and 68 unmatched subjects meeting the same entry criteria (51 dexfenfluramine patients and 17 controls). Mean treatment duration was 6.9 months; mean interval from treatment discontinuation to echocardiogram was 8.5 months. Each echocardiogram was interpreted independently by 3 echocardiographers. FDA-grade regurgitation (at least mild aortic regurgitation or at least moderate mitral regurgitation) was significantly more frequent in dexfenfluramine patients (7.6% versus 2.1% for controls;\n            <jats:italic>P<\/jats:italic>\n            =0.01; odds ratio, 3.82). This difference was primarily due to more frequent mild aortic regurgitation in dexfenfluramine patients (6.3% versus 1.6% in controls;\n            <jats:italic>P<\/jats:italic>\n            &lt;0.02; odds ratio, 4.15). No differences were found in sclerosis or mobility for either the aortic or mitral valve. Factors independently related to FDA-grade regurgitation or any grade of aortic regurgitation were older age, higher diastolic blood pressure at the time of echocardiography, and shorter time from drug discontinuation to echocardiogram.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014Dexfenfluramine use is associated with an increase in the prevalence of abnormal valve regurgitation. Age and blood pressure may also affect the prevalence of regurgitation. Dexfenfluramine-related valve regurgitation may regress after drug discontinuation.\n          <\/jats:p>","DOI":"10.1161\/01.cir.100.21.2161","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:42:29Z","timestamp":1339461749000},"page":"2161-2167","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":69,"title":["Prevalence and Determinants of Valvulopathy in Patients Treated With Dexfenfluramine"],"prefix":"10.1161","volume":"100","author":[{"given":"Bruce K.","family":"Shively","sequence":"first","affiliation":[{"name":"From the Cardiology Divisions of Oregon Health Sciences University (B.K.S.), Portland, Ore; the University of New Mexico (C.A.R.), Albuquerque; the University of Colorado Health Sciences Center (E.A.G.), Denver, Co; and Research and Development, Interneuron Pharmaceuticals, Inc (T.N., S.B.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos A.","family":"Roldan","sequence":"additional","affiliation":[{"name":"From the Cardiology Divisions of Oregon Health Sciences University (B.K.S.), Portland, Ore; the University of New Mexico (C.A.R.), Albuquerque; the University of Colorado Health Sciences Center (E.A.G.), Denver, Co; and Research and Development, Interneuron Pharmaceuticals, Inc (T.N., S.B.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward A.","family":"Gill","sequence":"additional","affiliation":[{"name":"From the Cardiology Divisions of Oregon Health Sciences University (B.K.S.), Portland, Ore; the University of New Mexico (C.A.R.), Albuquerque; the University of Colorado Health Sciences Center (E.A.G.), Denver, Co; and Research and Development, Interneuron Pharmaceuticals, Inc (T.N., S.B.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Najarian","sequence":"additional","affiliation":[{"name":"From the Cardiology Divisions of Oregon Health Sciences University (B.K.S.), Portland, Ore; the University of New Mexico (C.A.R.), Albuquerque; the University of Colorado Health Sciences Center (E.A.G.), Denver, Co; and Research and Development, Interneuron Pharmaceuticals, Inc (T.N., S.B.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja Barton","family":"Loar","sequence":"additional","affiliation":[{"name":"From the Cardiology Divisions of Oregon Health Sciences University (B.K.S.), Portland, Ore; the University of New Mexico (C.A.R.), Albuquerque; the University of Colorado Health Sciences Center (E.A.G.), Denver, Co; and Research and Development, Interneuron Pharmaceuticals, Inc (T.N., S.B.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199708283370901"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199708283370911"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199708283370913"},{"key":"e_1_3_2_4_2","unstructured":"Cardiac valvulopathy associated with exposure to fenfluramine or dexfenfluramine: U.S. Department of Health and Human Services interim public health recommendations November 1997. MMWR Morb Mortal Wkly Rep. 1997:46:1061\u20131066."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199809103391103"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199809103391102"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-129-11_Part_1-199812010-00005"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199809103391101"},{"key":"e_1_3_2_9_2","first-page":"771","volume":"339","year":"1998","unstructured":"Cannistra LB, Cannistra AJ. Regression of multivalvular regurgitation after the cessation of fenfluramine and phentermine treatment. N Engl J Med. 1998;339:771. 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J Am Coll Cardiol. 1991;17(suppl B):101B\u2013110B.","DOI":"10.1016\/0735-1097(91)90945-6"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.100.21.2161","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T13:22:12Z","timestamp":1715520132000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.100.21.2161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,11,23]]},"references-count":16,"journal-issue":{"issue":"21","published-print":{"date-parts":[[1999,11,23]]}},"alternative-id":["10.1161\/01.CIR.100.21.2161"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.100.21.2161","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,11,23]]},"assertion":[{"value":"1999-05-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-07-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-11-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}