Gender effects on cardiac valvular function in hyperprolactinaemic patients receiving cabergoline: a retrospective study.
BACKGROUND
Ergot-derived dopamine agonists are associated with increased risk of valvular dysfunction in Parkinson's disease. The risk of valvular disease associated with lower doses of cabergoline used to treat prolactinomas remains controversial.


OBJECTIVE
To determine whether there is an association of cabergoline and valvular function in patients with hyperprolactinaemia according to gender.


METHODS
Case-record retrospective study.


METHODS
Outpatient neuroendocrine clinical centre at a tertiary care hospital.


METHODS
One hundred patients (48 men and 52 women) with hyperprolactinaemia who had an echocardiogram while receiving cabergoline for at least 6 months.


METHODS
One hundred controls (48 men and 52 women) selected from Massachusetts general hospital (MGH) database of echocardiograms without clinically significant findings, matched to patients for age, gender, body mass index (BMI) and hypertension.


METHODS
Echocardiogram.


RESULTS
There were no significant differences in valvular function in patients compared with controls. However, women patients had a higher prevalence of mild tricuspid regurgitation (TR) than female controls (15.4%vs. 1.9%, P = 0.03). Among men only, patients had more trace TR than controls (68.8%vs. 45.8%, P = 0.02). The mild valvular regurgitation in patients was not clinically significant and did not correlate with dose, duration or cumulative dose.


CONCLUSIONS
Overall cabergoline was not associated with valvulopathy. However, subdivided by gender, hyperprolactinaemic men and women had higher prevalence of trace or mild TR, respectively, compared with gender matched controls. There may be gender differences in valvular dysfunction associated with cabergoline. Longer term, larger studies are necessary to evaluate definitively an effect of cabergoline on valvular function in hyperprolactinaemic patients.
Nachtigall
Lisa B
LB
Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. lnachtigall@partners.org
Valassi
Elena
E
Lo
Janet
J
McCarty
David
D
Passeri
Jonathan
J
Biller
Beverly M K
BM
Miller
Karen K
KK
Utz
Andrea
A
Grinspoon
Steven
S
Lawson
Elizabeth A
EA
Klibanski
Anne
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D000077465:Cabergoline; D016022:Case-Control Studies; D004452:Echocardiography; D004873:Ergolines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006351:Heart Valves / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology*; D006727:Hormone Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D006966:Hyperprolactinemia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D011388:Prolactin / Q000037:antagonists & inhibitors; D015175:Prolactinoma / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D012189:Retrospective Studies; D012727:Sex Characteristics; D055815:Young Adult
D000970:Antineoplastic Agents; D004873:Ergolines; D006727:Hormone Antagonists; D011388:Prolactin; D000077465:Cabergoline