title: Bromocriptine induces regression of left ventricular hypertrophy in peritoneal dialysis patients.
abstract: Left ventricular hypertrophy (LVH) prevalence is very high in end stage renal disease (ESRD). It's a predictor of cardiac death in peritoneal dialysis patients. Noradrenalin, Angiotensin II and aldosterone are involved incardiac hypertrophy. Dopamine, acting at DA2 receptors inhibits norephinephrin release, antagonizes aldosterone and down-regulates AT1 receptor numbers, suggesting that DA2 agonists, like bromocriptine (BEC) could regress LVH. The objective of this study was to evaluate the changes in left ventricular mass in patients with ESRD in continuous ambulatory peritoneal dialysis (CAPD), by adding BEC to the treatment. An open clinical trial was conducted. Twenty patients were enrolled. Five formed the control group. Fifteen patients in the experimental group received BEC 2.5 mg three times daily over three months. M mode echocardiography and prolactin plasma levels were measured at the beginning and at the end of the study. The statistical analysis was performed using Student t test. The echocardiography reports showed a 24.4% decreased in left ventricular mass index (LVMI); the interventricular septum decreased 11.3%, the ejection fraction was not modified. The control group showed no difference. BEC-mediated decreases in left-ventricular mass in LVH patients on dialysis suggest that Dopaminergic agonists could be useful in caring for patients with ESRD and LVH.
authors.affiliation: Coordinación de Educación e Investigación en Salud, Unidad de Medicina Familiar Number 80, Instituto Mexicano del Seguro Social, Morelia, Mich. olivamejia@yahoo.com
authors.forename: Oliva
authors.initials: O
authors.lastname: Mejía-Rodríguez
authors.forename: Cleto
authors.initials: C
authors.lastname: Alvarez-Aguilar
authors.forename: Helios Eduardo
authors.initials: HE
authors.lastname: Vega-Gómez
authors.forename: Francisco
authors.initials: F
authors.lastname: Belio-Caro
authors.forename: Juan M
authors.initials: JM
authors.lastname: Vargas-Espinosa
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Paniagua-Sierra
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D001971:Bromocriptine / Q000627:therapeutic use*; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004452:Echocardiography; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011388:Prolactin / Q000097:blood
chemical_list: D018491:Dopamine Agonists; D001971:Bromocriptine; D011388:Prolactin