0562: Long term outcome of patients with benfluorex-induced mitral regurgitation and first episode of heart failure

Abstract

Benfluorex’s imputability in drug-induced valvular heart disease (DIVHD) is now well established. However no data about long term clinical and echocardiographic follow-up of patients suffering from benfluorexrelated DIVHD are available. The present study was conducted to address this issue. Between January 2003 and June 2012, after an exhaustive analysis of our database, 20 patients (55±9 years, 90% women, body mass index: 32.9±9 kg/m²) hospitalized for heart failure were retrospectively identified with benfluorex induced moderate or severe mitral regurgitation (MR). Initially 70% of them presented NYHA class III or IV. MR was quantified as moderate in 11, moderate to severe in 8 and severe in one patient. Aortic regurgitation (AR) was also present in 17 patients (85%): mild in 5, moderate in 9 and moderate to severe in 3 patients. During a median follow-up of 7 years, heart failure episodes led to 53388 Valve replacements. Two patients died, one in the surgical group and one in the medical group. Among survivors, NYHA class improved in 6 patients in the surgical group but only in 4 in the medical group. After withdrawal of benfluorex, MR decreased in 7 patients and AR decreased in 5 patients. MR was stable in 3 patients and AR in 4 patients. A worsening of MR was not observed and AR worsened in 2 patients. After an hospitalization for a first episode of heart failure related to benfluorex-induced MR, patients are exposed to a large number of cardiac events including repeated hospitalizations and death.