title: Low incidence of restrictive valvulopathy in patients with Parkinson's disease on moderate dose of pergolide.
abstract: Restrictive valvular heart disease (VHD) has recently been reported in Parkinson's disease (PD) patients treated with ergot dopamine agonists. The aim of the present study was to detect valvular changes in our patients and to investigate their relationship to long-term use of pergolide. We examined 90 patients (mean age 60.8 +/- SD 9.5 years) with PD, average duration 10.0 +/- 5.1 years. Mean pergolide dose was 2.93 +/- 0.75 (range 0.75 to 5) mg per day. 36 subjects (mean age 55.0 +/- 12.8 years) served as controls. All subjects underwent transthoracic echo-Doppler examination. Valve morphology was rated as normal, fibrotic, restrictive, or degenerative. In addition, the mitral tenting area (TA) and tenting distance (TD) were assessed. In 40 out of 90 (45%) PD patients and in 13 out of 36 (36%) controls, mild mitral regurgitation was observed. In 1 PD patient, a moderate mitral regurgitation was recorded. However, no case of restrictive VHD was found. Neither the TA (1.44 +/- 0.24 cm(2) vs 1.33 +/- 0.44 cm(2)) nor the TD (0.73 +/- 0.10 cm vs. 0.72 +/- 0.30 cm) differed from controls. There were no correlations between the current or cumulative dose of pergolide and TA or TD. Discrete fibrotic changes on valves were found in 10 out of 90 (11%) patients. Degenerative changes of valves were found in 11 (12%) patients and in 7 (19 %) controls. Thus in contrast to earlier findings of restrictive VHD in up to one-third of PD patients on pergolide, we did not find any significant heart disease. We only observed mild to moderate mitral regurgitation and clinically insignificant valvular fibrosis. A possible reason for such a discrepancy is that the daily doses of pergolide in our patients were inferior to those reported previously. In conclusion, the prevalence of restrictive VHD has been lower than expected in our patients with PD, probably in relation to moderate daily doses of pergolide.
authors: Department of Neurology, 1st School of Medicine Charles University, Katerinská 30, Prague, CZ-12000, The Czech Republic. eruzi@lf1.cuni.cz
authors: Evzen
authors: E
authors: Růzicka
authors: Hana
authors: H
authors: Línková
authors: Martin
authors: M
authors: Penicka
authors: Olga
authors: O
authors: Ulmanová
authors: Lucie
authors: L
authors: Nováková
authors: Jan
authors: J
authors: Roth
mesh_terms: D000368:Aged; D018491:Dopamine Agonists / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004452:Echocardiography / Q000379:methods; D005260:Female; D006349:Heart Valve Diseases / Q000139:chemically induced* / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000187:drug effects / Q000503:physiopathology; D010300:Parkinson Disease / Q000188:drug therapy; D010479:Pergolide / Q000009:adverse effects*
chemical_list: D018491:Dopamine Agonists; D010479:Pergolide
references: J Am Soc Echocardiogr. 1990 Jan-Feb;3(1):54-63
references: 2310593
references: Mov Disord. 2006 Aug;21(8):1261-4
references: 16685692
references: Mov Disord. 2006 Aug;21(8):1109-13
references: 16622856
references: Mov Disord. 2004 Jun;19(6):699-704
references: 15197712
references: N Engl J Med. 2007 Jan 4;356(1):39-46
references: 17202454
references: Mayo Clin Proc. 2002 Dec;77(12):1280-6
references: 12479512
references: Am J Cardiol. 1999 Mar 15;83(6):897-902
references: 10190406
references: Mov Disord. 2004 Jun;19(6):656-62
references: 15197703
references: Lancet. 2004 Apr 10;363(9416):1179-83
references: 15081648
references: Mov Disord. 2006 Apr;21(4):586-7
references: 16482572
references: Neurology. 2004 Jul 27;63(2):301-4
references: 15277624
references: Mayo Clin Proc. 2003 Jun;78(6):730-1
references: 12934784
references: J Neurol Neurosurg Psychiatry. 1999 Jan;66(1):79-81
references: 9886458
references: Mov Disord. 2004 Dec;19(12):1524-5
references: 15515031
references: Mayo Clin Proc. 2005 Aug;80(8):1016-20
references: 16092580
references: Cas Lek Cesk. 2005;144(2):123-6
references: 15807300