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  1. Article: Appetite-suppressing drugs and valvular heart disease.

    Cannistra, L B / Gaasch, W H

    Cardiology in review

    2001  Volume 7, Issue 6, Page(s) 356–361

    Abstract: The popular diet drugs, fenfluramine and dexfenfluramine, were withdrawn from the market in the United States after the publication of an association of these drugs with valvulopathy in a small series of patients, spontaneous reports to the Food and Drug ...

    Abstract The popular diet drugs, fenfluramine and dexfenfluramine, were withdrawn from the market in the United States after the publication of an association of these drugs with valvulopathy in a small series of patients, spontaneous reports to the Food and Drug Administration, and echocardiographic surveys that suggested a valvulopathy prevalence of 32.8% among diet drug users. Subsequent publications suggested that there is an association of these agents with valvulopathy, but that the prevalence seems lower than initially suspected. This review examines the available prevalence data and attempts to account for some of the variability in these data. Potential pathophysiologic mechanisms are discussed and management guidelines for these patients are provided. This is an area of ongoing study and more information about the natural history of these lesions will certainly be forthcoming. A review of the data reveals that the withdrawal of these agents was prudent and likely prevented further harm.
    MeSH term(s) Appetite Depressants/adverse effects ; Dexfenfluramine/adverse effects ; Echocardiography ; Fenfluramine/adverse effects ; Heart Valve Diseases/chemically induced ; Heart Valve Diseases/diagnostic imaging ; Heart Valve Diseases/epidemiology ; Humans ; Phentermine/adverse effects ; Prevalence ; Serotonin Receptor Agonists/adverse effects ; United States/epidemiology
    Chemical Substances Appetite Depressants ; Serotonin Receptor Agonists ; Fenfluramine (2DS058H2CF) ; Phentermine (C045TQL4WP) ; Dexfenfluramine (E35R3G56OV)
    Language English
    Publishing date 2001-01-31
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1294965-6
    ISSN 1061-5377
    ISSN 1061-5377
    DOI 10.1097/00045415-199911000-00014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4491: Show issues Location:
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  2. Article: Regression of multivalvular regurgitation after the cessation of fenfluramine and phentermine treatment.

    Cannistra, L B / Cannistra, A J

    The New England journal of medicine

    1998  Volume 339, Issue 11, Page(s) 771

    MeSH term(s) Adult ; Appetite Depressants/adverse effects ; Drug Combinations ; Female ; Fenfluramine/adverse effects ; Heart Valve Diseases/chemically induced ; Humans ; Obesity/drug therapy ; Phentermine/adverse effects ; Remission Induction
    Chemical Substances Appetite Depressants ; Drug Combinations ; Fenfluramine (2DS058H2CF) ; Phentermine (C045TQL4WP)
    Language English
    Publishing date 1998-09-10
    Publishing country United States
    Document type Case Reports ; Letter
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/nejm199809103391112
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Valvular heart disease associated with dexfenfluramine.

    Cannistra, L B / Davis, S M / Bauman, A G

    The New England journal of medicine

    1997  Volume 337, Issue 9, Page(s) 636

    MeSH term(s) Adult ; Appetite Depressants/adverse effects ; Female ; Fenfluramine/adverse effects ; Heart Valve Diseases/chemically induced ; Humans ; Mitral Valve Insufficiency/chemically induced
    Chemical Substances Appetite Depressants ; Fenfluramine (2DS058H2CF)
    Language English
    Publishing date 1997-08-28
    Publishing country United States
    Document type Case Reports ; Letter
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/nejm199708283370912
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Moderate-high intensity exercise training after myocardial infarction: effect on left ventricular remodeling.

    Cannistra, L B / Davidoff, R / Picard, M H / Balady, G J

    Journal of cardiopulmonary rehabilitation

    1999  Volume 19, Issue 6, Page(s) 373–380

    Abstract: Background: Regular exercise increases exercise capacity and physical fitness, but questions remain about the effects of exercise on left ventricle (LV) remodeling after myocardial infarction. This study investigated the effects of moderate to high ... ...

    Abstract Background: Regular exercise increases exercise capacity and physical fitness, but questions remain about the effects of exercise on left ventricle (LV) remodeling after myocardial infarction. This study investigated the effects of moderate to high intensity exercise training on LV remodeling after a first myocardial infarction.
    Methods: An exercise group of 68 patients in cardiac rehabilitation after a first myocardial infarction had an initial echocardiogram and exercise stress test. Thirty patients completed the 12 weeks of training and had echocardiograms suitable for quantitative analysis. Follow-up echocardiograms and exercise tests were performed. A carefully matched control group of 30 patients with echocardiograms at fixed intervals after myocardial infarction and no formal exercise training were also studied. LV size was expressed as the endocardial surface area-to-body surface area (ESAi), whereas infarct size was characterized by the percent abnormal wall motion (%AWM) by echocardiography using an endocardial surface area mapping technique. Indices of LV shape (sphericity) were also assessed.
    Results: In the exercise group, no significant changes were seen in ESAi (57.95 +/- 13.1 vs 57.80 +/- 12.04 cm2/m2) or in %AWM (19.33 +/- 15.27 vs 20.11 +/- 15.95) from the initial to the final echo. The indices of sphericity were also unchanged. None of these parameters changed in the control group. Within each group was found heterogeneity in LV remodeling. Multivariate regression analysis revealed initial ESAi and initial %AWM to predict change in ESAi over time.
    Conclusions: In this study of patients with predominately small infarcts, exercise training did not adversely affect LV remodeling after myocardial infarction. Remodeling is heterogeneous and appears related to infarct and LV size.
    MeSH term(s) Aged ; Electrocardiography ; Exercise Therapy ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/diagnostic imaging ; Myocardial Infarction/physiopathology ; Myocardial Infarction/rehabilitation ; Regression Analysis ; Ultrasonography ; Ventricular Remodeling
    Language English
    Publishing date 1999-11
    Publishing country United States
    Document type Clinical Trial ; Journal Article
    ZDB-ID 632679-1
    ISSN 0883-9212 ; 0275-1429
    ISSN 0883-9212 ; 0275-1429
    DOI 10.1097/00008483-199911000-00009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1998: Show issues Location:
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  5. Article: Comparison of outcome of cardiac rehabilitation in black women and white women.

    Cannistra, L B / O'Malley, C J / Balady, G J

    The American journal of cardiology

    1995  Volume 75, Issue 14, Page(s) 890–893

    Abstract: Coronary artery disease is the leading cause of death among black women in the United States. Black women also demonstrate a greater prevalence of coronary risk factors and a higher mortality after myocardial infarction than white women. To evaluate the ... ...

    Abstract Coronary artery disease is the leading cause of death among black women in the United States. Black women also demonstrate a greater prevalence of coronary risk factors and a higher mortality after myocardial infarction than white women. To evaluate the clinical profile and outcome of black women in an urban-based cardiac rehabilitation program, 35 black women (aged 54 +/- 13 years) and 47 white women (aged 57 +/- 10 years) were prospectively studied. Black women had similar admitting diagnoses as white women, with recent myocardial infarction being the most common (37%). Coronary risk factors were more prevalent in black women than white women in the program: hypertension (71% vs 53%; p = 0.09) diabetes mellitus (46% vs 26%; p = 0.06), obesity (74% vs 49%; p < 0.05). Cholesterol and high-density lipoprotein levels were similarly elevated in black (251 +/- 53 mg/dl) and in white (248 +/- 52 mg/dl) women, whereas 34% of black and 21% of white women were active smokers. There was no significant difference in initial exercise capacity at program entry. Fewer black women (51%) completed the 12-week program than white women (64%), p = NS. Comparison of initial and follow-up exercise tests after 12 weeks of moderate to high-intensity dynamic exercise demonstrated significant and similar improvements in functional capacity in both black (4.2 +/- 1.6 vs 5.6 +/- 1.7 METs; p < 0.001) and white (4.8 +/- 2.2 vs 5.7 +/- 2.2 METs; p < 0.01) women. Among obese patients, only the white women lost weight.(ABSTRACT TRUNCATED AT 250 WORDS)
    MeSH term(s) African Continental Ancestry Group ; Boston ; Coronary Disease/ethnology ; Coronary Disease/rehabilitation ; European Continental Ancestry Group ; Exercise Therapy ; Female ; Humans ; Middle Aged ; Myocardial Infarction/ethnology ; Myocardial Infarction/rehabilitation ; Outcome Assessment (Health Care) ; Patient Compliance ; Prospective Studies ; Risk Factors ; Urban Population
    Language English
    Publishing date 1995-05-01
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 80014-4
    ISSN 1879-1913 ; 0002-9149
    ISSN (online) 1879-1913
    ISSN 0002-9149
    DOI 10.1016/s0002-9149(99)80682-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Comparison of the clinical profile and outcome of women and men in cardiac rehabilitation.

    Cannistra, L B / Balady, G J / O'Malley, C J / Weiner, D A / Ryan, T J

    The American journal of cardiology

    1992  Volume 69, Issue 16, Page(s) 1274–1279

    Abstract: Few data are available regarding the outcome of women in cardiac rehabilitation. To determine whether women differ from men in clinical profile and outcome, 225 consecutive patients were prospectively evaluated in an urban, multidisciplinary, exercise- ... ...

    Abstract Few data are available regarding the outcome of women in cardiac rehabilitation. To determine whether women differ from men in clinical profile and outcome, 225 consecutive patients were prospectively evaluated in an urban, multidisciplinary, exercise-based cardiac rehabilitation program. Among the 51 women (age 56 +/- 10) and 174 men (age 54 +/- 10), most were: white (84%), married (64%), employed (63%), had had myocardial infarction or revascularization, or both (66%), and traveled less than 10 miles to the program (92%). Risk profiles revealed obesity in 48% (mean Metropolitan Relative Weight = 124 +/- 22%), hypertension in 47%, smoking in 23%, diabetes in 16%, and mean cholesterol of 236 +/- 45 mg/dl. Compared with men, more women were nonwhite, unemployed, unmarried, hypertensive or diabetic (p less than 0.0001) and had higher cholesterol (p less than 0.01). Compliance rates were similar for women (51%) and men (63%) (p = not significant). Univariate predictors of program noncompliance differed between women and men. Initial exercise capacity was less for women than for men, but both groups achieved a similar training effect. Women increased their exercise time by 31% and peak METs by 30%, whereas men showed a 21% increase in exercise time and 16% increase in peak METs achieved (p less than 0.001). Thus, in this cardiac rehabilitation program, women have a less favorable risk factor profile and differ from men with regard to baseline demographics and predictors of program completion. Women, however, have similar rates of compliance and achieve the same improvement in functional capacity with training.
    MeSH term(s) Adult ; Coronary Disease/rehabilitation ; Exercise Test ; Female ; Humans ; Male ; Middle Aged ; Patient Compliance ; Risk Factors ; Sex Factors ; Treatment Outcome
    Language English
    Publishing date 1992-05-15
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 80014-4
    ISSN 1879-1913 ; 0002-9149
    ISSN (online) 1879-1913
    ISSN 0002-9149
    DOI 10.1016/0002-9149(92)91220-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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