Background and objectives .– Restrictive valvular heart disease has recently been reported in patients after benfluorex exposure. However, little is known about its prevalence and echocardiographic features. The aim of our study was to assess the prevalence of benfluorex exposure in patients with restrictive mitral or aortic valve disease and to describe their echocardiographic characteristics.

Methods .– In a single center study, patients with a final diagnosis of unexplained restrictive aortic and/or mitral valvular disease were studied. Only patients with at least moderate valvular regurgitation were included. All echocardiographic records were analysed by two experienced observers. Patients were interrogated for their previous use of benfluorex or other appetit-suppressant drugs.

Results .– Sixty-eight consecutive patients, aged 58 ± 9 years, with restrictive aortic and/or mitral valvular disease were studied, including 63 (93%) women. Among them, 54 (82%) had had previous treatment with appetit-suppressant drugs, including benfluorex alone in 19 (28%) patients, or in combination with another appetit-suppressant drug, mainly dexfenfluramine, in the remaining cases. Among patients with both mitral and aortic involvement, 39 (97%) had been exposed to benfluorex, isolated ( n = 14) or in combination with another appetit-suppressant drug ( n = 25). Echocardiographic features included combined mitral and aortic regurgitation with restricted valve motion in 40 (59%) cases, and isolated mitral or aortic involvement in 5 and 12 patients, respectively.

Conclusion .– The prevalence of appetit-suppressant drugs exposure is very high in patients with left heart restrictive valvular regurgitation. Multiple drugs exposure is frequent in these patients. Combined aortic and mitral restrictive valve regurgitation is highly suggestive of valvulopathy associated with benfluorex or other appetit-suppressant drug valve disease.