Abstract
This editorial refers to ‘Valvular heart disease associated with benfluorex therapy: results from the French multicenter registry’ by F.L. Ven et al ., doi:10.1093/ejechocard/jeq172 . The first case reports about drug-induced valvular heart disease (VHD) date from the 1960s with the use of ergot-derived drugs (methysergide and ergotamine) for the treatment of migraine.1 Nevertheless, public awareness about this particular entity came after the withdrawal of the appetite suppressant fenfluramine (Fen-Phen) in 1997.2 Thereafter a limited number of drugs have been added to this list such as pergolide, cabergoline, and MDMA (the main component of Ecstasy).3–5 The hallmark feature of these drugs or their metabolites is serotonin 2B (5-HT2B) receptor overstimulation, with valvular fibroblast proliferation and production of myxoid substance as a consequence.6 This leads to reduced leaflet mobility (restrictive VHD) due to superficial plaque like thickening of the valvular leaflets and subvalvular apparatus. Both …
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