Téma: Overview works

Serotoninergic valvulopathies

Juraj Hrnčiar, Viera Kiková, Mária Hrnčiarová

The work presents an overview of acquired valvular heart diseases caused by the abundance of serotonine. First cases were described at the carcinoid of gastrointestinal tract, which was producing an excessive amount of serotonine from hepatal metastases. Later valvulopathies after use of metylsergid and ergotamine (alcaloids used to cure migraine) were observed. Most cases were observed at the end of the 20th century when anorectics fenfluramine and fenteramine were widely used to cure obesity. Therefore these medicaments were contraindicated by the FDA in the year 1997. The abundance of serotonine has a proinflamatory and fibrotising effect, which gives rise to valvular heart diseases and pulmonary hypertension. This abundance alone originates not only by overproduction as at carcinoide, but also by the increased release and inhibition of reuptake of serotonine in synapsies and neuronal endings. Anorectics and antidepressants of the 1st and 2nd generation work by this mechanism, but by the selective inhibition of reuptake also antidepressants of the 3th generation (type SSRI - selective serotonine reuptake inhibitors) and the anorecticum sibutramine (SNRI - serotonine noradrenaline reuptake inhibitor). Acquired valvular heart diseases and pulmonary hypertension could therefore be observed also after the longtime use of these medicaments, as our first case (mentioned in this article) confirms.

Ročník 2006  Témy časopisu Internal medicine 7 / 2006

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