B-type natriuretic peptide and cardiovalvulopathy in Parkinson disease with dopamine agonist.
OBJECTIVE
To elucidate the usefulness of plasma B-type natriuretic peptide (BNP) values for evaluating adverse effects of pergolide or cabergoline on cardiovalvulopathy in patients with Parkinson disease.


METHODS
Twenty-five patients treated with pergolide or cabergoline (ergot group) and 25 patients never treated with ergot derivatives (non-ergot group) were enrolled. Plasma BNP values and detailed echocardiography were evaluated. Thirty age- and gender-matched controls were similarly evaluated.


RESULTS
Patients with regurgitation more than grade 3 were more frequent in the ergot group than in the non-ergot group as well as control groups (24%, 0%, 3%, p = 0.001). Both composite regurgitation scores and plasma BNP values were significantly higher in the ergot group than in controls. In the ergot group, the cumulative dose correlated to both tenting area (r = 0.57, p = 0.004) and tenting distance (r = 0.62, p = 0.001). Furthermore, plasma BNP values were higher in patients with severe or multiple regurgitation groups (p < 0.001), and were correlated with composite regurgitation score (r = 0.70, p < 0.001). Multiple regression analyses revealed that BNP values were independently correlated with both composite regurgitation and left ventricular ejection fraction.


CONCLUSIONS
The combination of comprehensive echocardiography and plasma B-type natriuretic peptide levels elucidates the presence of cardiac damage in patients with Parkinson disease using ergot derivative dopamine agonists.
Watanabe
H
H
Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
Hirayama
M
M
Noda
A
A
Ito
M
M
Atsuta
N
N
Senda
J
J
Kaga
T
T
Yamada
A
A
Katsuno
M
M
Niwa
T
T
Tanaka
F
F
Sobue
G
G
D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D018491:Dopamine Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000097:blood* / Q000139:chemically induced / Q000150:complications; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010300:Parkinson Disease / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D014262:Tricuspid Valve Insufficiency / Q000097:blood* / Q000139:chemically induced / Q000150:complications
D015415:Biomarkers; D018491:Dopamine Agonists; D020097:Natriuretic Peptide, Brain