| Regression of cardiac valvulopathy related to ergot-derived dopamine agonists. | |
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MedLine Citation:
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PMID: 20553285 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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. |
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Authors:
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Renzo Zanettini; Angelo Antonini; Gemma Gatto; Rosa Gentile; Silvana Tesei; Gianni Pezzoli |
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Publication Detail:
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Type: Journal Article Date: 2010-06-11 |
Journal Detail:
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Title: Cardiovascular therapeutics Volume: 29 ISSN: 1755-5922 ISO Abbreviation: Cardiovasc Ther Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-11-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101319630 Medline TA: Cardiovasc Ther Country: England |
Other Details:
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Languages: eng Pagination: 404-10 Citation Subset: IM |
Copyright Information:
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© 2010 Blackwell Publishing Ltd. |
Affiliation:
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Istituti Clinici di Perfezionamento Hospital, via Bignami 1, 20126 Milan, Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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