Document Detail


Heart abnormalities in Parkinson patients after discontinuation or continuation of ergot-derived dopamine agonists: a treatment-blinded echocardiographic study.
MedLine Citation:
PMID:  19852154     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: Ergot-derived dopamine agonists (DAs) are used in the treatment of Parkinson's disease, but may be associated with valvular heart disease and pulmonary hypertension. The study aim was to examine changes in cardiovascular abnormalities after the discontinuation or continuation of anti-parkinson treatment. METHODS: Parkinson patients treated with either ergot-derived (n = 32) or non-ergot-derived (n = 8) DAs who had been diagnosed with valvular abnormalities or pulmonary hypertension, were included in this one-year follow up study. After an initial echocardiography, five patients continued ergot-derived DA treatment, while the remaining 35 either changed (n = 27) or continued (n = 8) non-ergot-derived DA treatment. The patients were followed up after a mean of 14 months (range: 12-18 months). Changes in the severity of valve disease and pulmonary hypertension were evaluated by an analysis of digitally stored echocardiograms. The recordings were performed blinded to medical treatment, while the analyses were blinded to both the medical treatment and the timing of image acquisition. RESULTS: Follow up revealed the risk of worsening cardiovascular abnormalities to be 60% in patients who continued ergot-derived DA treatment, compared to 14% in those who changed to, or continued with, non-ergot-derived DA medication (p < 0.05). Overall, patients who changed from ergot-derived to non-ergot-derived DAs did not exhibit any significant worsening or improvement of their valve abnormality, although the pulmonary artery pressure (PAP) fell from 26 +/- 12 mmHg to 22 +/- 8 mmHg at follow up (p < 0.005). CONCLUSION: At one year after discontinuation of ergot-derived DAs, a mild but statistically significant reduction in PAP was detected. Overall, valvular regurgitation remained without definite worsening or improvement in these patients. Among patients who continued ergot-derived DAs despite a cardiovascular abnormality, the follow-up indicated an increased risk of worsening.
Authors:
Vibeke G Rasmussen; Steen H Poulsen; Erik Dupont; Karen Østergaard; Gholamhossein Safikhany; Henrik Egeblad
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  18     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-10-26     Completed Date:  2009-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  463-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. vibeke.guldbrand@ki.au.dk
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MeSH Terms
Descriptor/Qualifier:
Aged
Dopamine Agonists / adverse effects*
Ergot Alkaloids / adverse effects*
Female
Heart Valve Diseases / chemically induced*,  epidemiology,  ultrasonography
Humans
Hypertension, Pulmonary / chemically induced,  epidemiology
Male
Middle Aged
Mitral Valve / ultrasonography
Parkinson Disease / drug therapy*,  epidemiology,  ultrasonography
Chemical
Reg. No./Substance:
0/Dopamine Agonists; 0/Ergot Alkaloids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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