Cardiac valve regurgitation with pergolide compared with nonergot agonists in Parkinson disease.
BACKGROUND
Although most studies have suggested an increased risk of valvulopathy (primarily regurgitation) with pergolide mesylate use, one study suggested that this problem may also occur with use of the non-ergot-derived dopamine agonists pramipexole dihydrochloride and ropinirole hydrochloride.


OBJECTIVE
To determine if cardiac valve regurgitation occurs more commonly in patients with Parkinson disease (PD) treated with pergolide than in those treated with nonergot agonists at a comparable dose.


METHODS
A case-control study of echocardiographic findings of valve function in patients receiving dopamine agonists for PD.


METHODS
University-based referral center. Patients Thirty-six patients with idiopathic PD taking pergolide were compared with a matched control group of patients taking nonergot agonists with regard to the frequency and severity of cardiac valve regurgitation. Main Outcome Measure Valve scores (1 indicates trace; 2, mild; 3, moderate; and 4, severe) for the pergolide group were compared with those for the nonergot agonist control group.


RESULTS
The mean +/- SD valve regurgitation scores in the matched pergolide group compared with the nonergot group were as follows: aortic, 0.83 +/- 1.23 vs 0.19 +/- 0.53 (P = .01); mitral, 1.42 +/- 1.0 vs 0.39 +/- 0.65 (P<.001); and tricuspid, 1.43 +/- 1.0 vs 0.19 +/- 0.53 (P<.001). Lifetime exposure to a dopamine agonist was not statistically different between the pergolide and nonergot agonist groups (P = .18).


CONCLUSIONS
These data strengthen the conclusion that pergolide contributes to cardiac valve regurgitation when used in the long term as a treatment for PD. There appears to be low risk of cardiac valve regurgitation when using non-ergot-derived dopamine agonists.
Dewey
Richard B
RB
Department of Neurology and Division of Cardiology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-9036, USA. richard.dewey@utsouthwestern.edu
Reimold
Sharon C
SC
O'Suilleabhain
Padraig E
PE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000009:adverse effects*; D052160:Benzothiazoles / Q000009:adverse effects; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006349:Heart Valve Diseases / Q000139:chemically induced*; D006801:Humans; D007211:Indoles / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology*; D010479:Pergolide / Q000009:adverse effects*; D000077487:Pramipexole
D000978:Antiparkinson Agents; D052160:Benzothiazoles; D007211:Indoles; C046649:ropinirole; D010479:Pergolide; D000077487:Pramipexole