Meta-analysis of heart valve abnormalities in Parkinson's disease patients treated with dopamine agonists.
Valvular heart disease in patients being treated with ergot-derivative dopamine agonists (Ergot-DA) for Parkinson's disease has been reported to occur as a consequence of serotonine receptor stimulation. Goal of this analysis was to estimate the incidence of those changes from recently published studies and to determine its clinical relevance. Medline searches were performed to identify cross-sectional, echocardiographic studies comparing patients treated with dopamine agonists or controls, in terms of valvular changes. Observational studies of valve changes in Parkinsonian patients were used to estimate the incidence of severe valvulopathy. The results from 7 cross-sectional studies including 477 patients treated with Ergot-DA, 127 patients with non-Ergot-DA, and 364 control patients were analyzed. Moderate-to-severe valvular changes were detected in 26% of patients treated with Ergot-DA, 10% of patients treated with non-Ergot DA, and 10% of control patients. Severe valvulopathy was less than 1% both in cross-sectional and observational studies. The high rate of moderate valvular changes in patients treated with Ergot-DA suggests that close surveillance of the patients is required. Severe valvulopathy was less than 1% in the studies analyzed.
Simonis
Gregor
G
Department of Medicine/Cardiology, Heart Center, University of Technology, Dresden, Germany. gsimonis@gmx.de
Fuhrmann
Joerg T
JT
Strasser
Ruth H
RH
D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000077465:Cabergoline; D003430:Cross-Sectional Studies; D018491:Dopamine Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D004338:Drug Combinations; D004452:Echocardiography; D004873:Ergolines / Q000009:adverse effects / Q000627:therapeutic use; D004876:Ergot Alkaloids / Q000009:adverse effects* / Q000627:therapeutic use; D006349:Heart Valve Diseases / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D010300:Parkinson Disease / Q000188:drug therapy* / Q000453:epidemiology; D010479:Pergolide / Q000009:adverse effects / Q000627:therapeutic use; D011358:Product Surveillance, Postmarketing
D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D004338:Drug Combinations; D004873:Ergolines; D004876:Ergot Alkaloids; D010479:Pergolide; D000077465:Cabergoline