Valvular heart disease in Parkinson's disease patients treated with dopamine agonists: a reader-blinded monocenter echocardiography study.
Fibrotic valvular heart disease (VHD) has been reported in association with ergot dopamine agonists (DAs), but the current database is insufficient regarding clinical relevance and comparison to data on non-ergot DAs. We evaluated the effects of four DAs (pergolide, cabergoline, ropinirole, pramipexole) on morphology and function of heart valves in patients with Parkinson's disease (PD) to determine the frequency and clinical relevance of DA-induced VHD. A total of 85 patients treated with ergot or non-ergot DAs and 38 age-matched controls were evaluated by transthoracic echocardiography. Valvular pathology was assessed by established criteria of valvular regurgitation and a VHD scoring system. Both grading systems revealed increased frequency of VHD in ergot DA patients compared to both non-ergot DA patients and controls with 22% of ergot DA patients having moderate VHD versus 3% of non-ergot DA patients and none of controls (P = 0.001). We did not find correlations of echocardiographic findings with duration/cumulative dose of treatment, age, or vascular risk factors. Our data suggest that ergot DAs are associated with higher prevalence of VHD compared to non-ergot DAs and controls. Standard echocardiography seems sufficient to detect VHD in PD patients treated with DAs.
Junghanns
Susann
S
Department of Neurology, Technical University of Dresden, Dresden, Germany.
Fuhrmann
Joerg T
JT
Simonis
Gregor
G
Oelwein
Christian
C
Koch
Rainer
R
Strasser
Ruth H
RH
Reichmann
Heinz
H
Storch
Alexander
A
D052160:Benzothiazoles / Q000627:therapeutic use; D000077465:Cabergoline; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004311:Double-Blind Method; D004452:Echocardiography / Q000295:instrumentation*; D004873:Ergolines / Q000627:therapeutic use; D005260:Female; D005355:Fibrosis / Q000453:epidemiology / Q000473:pathology; D006349:Heart Valve Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000453:epidemiology; D007211:Indoles / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology; D010300:Parkinson Disease / Q000188:drug therapy* / Q000453:epidemiology*; D010479:Pergolide / Q000627:therapeutic use; D000077487:Pramipexole; D012720:Severity of Illness Index; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology
D052160:Benzothiazoles; D018491:Dopamine Agonists; D004873:Ergolines; D007211:Indoles; C046649:ropinirole; D010479:Pergolide; D000077487:Pramipexole; D000077465:Cabergoline