Reversible mitral and aortic regurgitation due to pioglitazone

Endocr Pract. 2012 Mar-Apr;18(2):e32-6. doi: 10.4158/EP11287.CR.

Abstract

Objective: To report the occurrence of pioglitazone-induced reversible valvular regurgitant lesions.

Methods: Clinical, laboratory, and imaging data are reported on a patient with known type 2 diabetes mellitus, who was prescribed pioglitazone to achieve better glycemic control.

Results: We present a case report of a 50-year-old woman, in whom diabetes had been diagnosed 5 years previously, who developed severe mitral and aortic regurgitation during 5 months of treatment with pioglitazone along with clinical and laboratory indications of fluid retention. Echocardiography 5 months after discontinued use of pioglitazone showed regression of regurgitant lesions and normalization of pertinent laboratory variables.

Conclusion: Five months of treatment with pioglitazone could potentially induce major cardiac valvular dysfunction, which was reversible in our patient. This report emphasizes the importance of carefully monitoring patients during treatment with thiazolidinediones.

Publication types

  • Case Reports

MeSH terms

  • Aortic Valve Insufficiency / chemically induced*
  • Aortic Valve Insufficiency / complications
  • Aortic Valve Insufficiency / physiopathology
  • Aortic Valve Insufficiency / therapy
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy
  • Drug Monitoring
  • Female
  • Humans
  • Hypoglycemic Agents / adverse effects*
  • Hypoglycemic Agents / therapeutic use
  • Middle Aged
  • Mitral Valve Insufficiency / chemically induced*
  • Mitral Valve Insufficiency / complications
  • Mitral Valve Insufficiency / physiopathology
  • Mitral Valve Insufficiency / therapy
  • Pioglitazone
  • Pyrazines / therapeutic use
  • Severity of Illness Index
  • Sitagliptin Phosphate
  • Thiazolidinediones / adverse effects*
  • Thiazolidinediones / therapeutic use
  • Treatment Outcome
  • Triazoles / therapeutic use

Substances

  • Hypoglycemic Agents
  • Pyrazines
  • Thiazolidinediones
  • Triazoles
  • Sitagliptin Phosphate
  • Pioglitazone