Cardiology Letters 2011, 20(3):238-245

Importance of serotonin in the etiopathogenesis of iatrogenic valvular heart diseases and pulmonary hypertension.

Hrnčiar J, Hrnčiarová M

Interná klinika FNsP F. D. Roosevelta v Banskej Bystrici, Slovenská republika

The work presents an overwiew of acquired valvular heart diseases caused by the abundance of serotonin from a carcinoid of the gastrointestinal tract, producing an excessive amount of serotonin from hepatal metastases. Later serotoninergic valvulopathies were observed after use of ergotamine and methylsergid (the alkaloid used to cure migraine). Most cases were observed at the end of the 20th century when the anorectics fenfluramine and feneteramine were widely used to cure obesity. As a result these medicaments were contraindicated by the FDA in the year 1997. The abundance of serotonin has a proinflammatory and fibrositing effect, which gives rise to valvular heart diseases (predominantly rergurgitations) and pulmonary hypertension. The abundance originates not only from overproduction at a carcinoid, but also by the increasing release and inhibition of serotonin reuptake in the synapsies and neuronal endings. Anorectics and antidepressants of the 1st and 2nd generation work by this mechaninism, and, by selective inhibition of reuptake, also antidepressants of the 3rd generation (type SSRI - selective serotonin reuptake inhibitors) and the anorecticum sibutramine (SNRI - serotonin noradrenaline reuptake inhibitor). Acquired valvular heart diseases and pulmonary hypertension could therefore be probably also caused by the longterm use of many medicaments, for example cabergoline and pergolite used for the therapy of prolactinoma and M. Parkinson.

Keywords: obesity; serotonin; anorectics; antidepressants; acquired valvular heart diseases; pulmonary hypertension

Published: March 1, 2011  Show citation