Possible Association Between 3,4-Methylenedioxymethamphetamine Abuse and Valvular Heart Disease - 16/08/11
, Bernard Cosyns, MD a, Hugo D’haenen, MD, PhD b, Edwin Creeten, MD a, Caroline Weytjens, MD a, Philippe R. Franken, MD, PhD a, Benjamin Scott, MD a, Danny Schoors, MD, PhD a, Arsène Kemdem, MD c, Laurent Close, MD c, Jean-Luc Vandenbossche, MD, PhD c, Serge Bechet, MD, PhD d, Guy Van Camp, MD, PhD a
Corresponding author: Tel: 00-32-2-477-32-52; fax: 00-32-2-477-6840.Résumé |
Valvular heart disease, inducing valvular regurgitation, has been described in users of drugs such as anorectic agents and ergot derivates. 3,4-Methylenedioxymethamphetamine (MDMA; “ecstasy”) also leads in vitro to the proliferation of cardiac valvular interstitial cells by activation of the 5-hydroxytryptamine 2B receptor. The aim of this study was to determine the occurrence of valvulopathy in young adults taking MDMA. Twenty-nine subjects using or having used MDMA and 29 gender- and age-matched controls were blindly evaluated with echocardiography. Eight subjects (28%) who took MDMA had abnormal echocardiographic results using the United States Food and Drug Administration’s criteria for appetite suppressant–induced valvular heart disease, compared with none in the control group (p = 0.0045). Six (21%) subjects had mitral regurgitation of 1/4 and 4 (14%) of ≥2/4, compared with none in the control group (p = 0.002). The mean mitral regurgitant area ratios (jet/atrium) were 12 ± 9.8% and 5 ± 1.3%, respectively (p = 0.007). Tricuspid regurgitation ≥2/4 was present in 13 MDMA users (45%) and absent in controls (p <0.001). The mean tricuspid regurgitant area ratios were 19 ± 9.5% and 9 ± 4.5%, respectively (p <0.001). Four MDMA users (14%) had mild aortic regurgitation (p = 0.11). Valvular “strands” were present in 6 MDMA users (21%) and in none of the controls (p = 0.02). In conclusion, MDMA may lead to mild to moderate valvular heart disease and valvular strands.
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Vol 100 - N° 9
P. 1442-1445 - novembre 2007 Retour au numéro
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