Document Detail


Regression of cardiac valvulopathy related to ergot-derived dopamine agonists.
MedLine Citation:
PMID:  20553285     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: In a previous echocardiographic prevalence study we reported a significant increase in the frequency of heart valve regurgitation in patients with Parkinson's disease taking the ergot-derived dopamine agonists pergolide and cabergoline versus controls. We followed-up our original cohort of patients to ascertain whether valvulopathy regressed after discontinuation of treatment and/or its incidence increased over time.
METHODS: Prospective follow-up of 101 patients treated with ergot-derived dopamine agonists included in the prevalence study: 53 given pergolide and 48 cabergoline (64% male; 66.4 ± 8.7 years of age, 11.5 ± 5.9 years of disease, 21.8 ± 5.9 months of follow-up); 55 stopped treatment while 46 continued. The main outcomes measures, were: echocardiographic quantification of regurgitant valve disease, abnormal leaflet, or cusp thickening and measurement of mitral valve tenting area.
RESULTS: Valve abnormalities regressed in about one third of patients with significant multivalvular and in about half of the patients with monovalvular regurgitation who withdrew; no progression was observed in remaining patients. Patients continuing ergot-derived dopamine agonists showed progression of cardiac valvulopathy: seven new cases with three to four regurgitation grade of any valve occurred during follow-up; this regarded also patients who had been on pergolide for many years.
CONCLUSION: Owing to the persistence of risk of heart valve damage over time and the lack of its mid-term reversibility in many patients, we believe that pergolide and cabergoline should be prescribed only when therapeutic alternatives with a better risk/benefit ratio are unavailable and the patient has access to echocardiography.
Authors:
Renzo Zanettini; Angelo Antonini; Gemma Gatto; Rosa Gentile; Silvana Tesei; Gianni Pezzoli
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-11
Journal Detail:
Title:  Cardiovascular therapeutics     Volume:  29     ISSN:  1755-5922     ISO Abbreviation:  Cardiovasc Ther     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-28     Completed Date:  2012-03-25     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  101319630     Medline TA:  Cardiovasc Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  404-10     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Affiliation:
Cardiac Rehabilitation Unit, Istituti Clinici diPerfezionamento, Via Bignami 1, Milan, Italy. renzo.zanettini@icp.mi.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antiparkinson Agents / adverse effects*
Dopamine Agonists / adverse effects*
Ergolines / adverse effects*
Female
Follow-Up Studies
Heart Valve Diseases / chemically induced*,  epidemiology,  ultrasonography
Humans
Italy / epidemiology
Male
Middle Aged
Parkinson Disease / drug therapy*,  epidemiology
Patient Selection
Pergolide / adverse effects*
Prevalence
Prognosis
Prospective Studies
Risk Assessment
Risk Factors
Time Factors
Chemical
Reg. No./Substance:
0/Antiparkinson Agents; 0/Dopamine Agonists; 0/Ergolines; 66104-22-1/Pergolide; LL60K9J05T/cabergoline

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


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