Pergolide use in Parkinson disease is associated with cardiac valve regurgitation.
OBJECTIVE
To determine if pergolide injures heart valves, by comparing echocardiographic findings in pergolide-treated patients with those of a historical control group.


METHODS
Letters were sent to all patients in the authors' practice believed to be taking pergolide, and those responders who wished to continue it were urged to undergo echocardiography. Echocardiograms were obtained on 46 patients, and scores for valvular regurgitation were compared with those from an age-matched control group derived from the Framingham Study. The composite valve regurgitation score was modeled as a linear function of total milligrams lifetime use of pergolide, controlling for age.


RESULTS
Eighty-nine percent of pergolide-treated patients had some degree of valvular insufficiency. For each of the three valves for which there are control data, we found an approximately 2- to 3-fold increased risk of abnormal valves in the pergolide patients (odds ratio [OR] approximately 3) and an estimated 14-fold increased risk of concerning tricuspid regurgitation (OR = 18.4). The composite valve score (the sum of valve scores for each of the four valves) was a function of lifetime pergolide use.


CONCLUSIONS
Pergolide may injure cardiac valves, resulting most commonly in tricuspid regurgitation.
University of Texas Southwestern Medical School, University of Texas Southwestern Medical Center, Dallas, TX 75390-9036, USA.
D G
DG
Baseman
P E
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O'Suilleabhain
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SC
Reimold
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Laskar
J G
JG
Baseman
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Dewey
D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001022:Aortic Valve Insufficiency / Q000139:chemically induced / Q000000981:diagnostic imaging; D002313:Cardiomyopathy, Restrictive / Q000139:chemically induced; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006349:Heart Valve Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000139:chemically induced / Q000000981:diagnostic imaging; D010300:Parkinson Disease / Q000188:drug therapy*; D010479:Pergolide / Q000009:adverse effects* / Q000627:therapeutic use; D010493:Pericarditis / Q000139:chemically induced; D011665:Pulmonary Valve Insufficiency / Q000139:chemically induced / Q000000981:diagnostic imaging; D016037:Single-Blind Method; D014262:Tricuspid Valve Insufficiency / Q000139:chemically induced / Q000000981:diagnostic imaging; D014463:Ultrasonography
D000978:Antiparkinson Agents; D010479:Pergolide