title: Severe tricuspid regurgitation in a patient receiving low-dose cabergoline for the treatment of acromegaly.
abstract: Cabergoline, an ergot-derived dopamine receptor agonist, is used widely in the treatment of Parkinson's disease (PD) and hyperprolactinemia, but may cause heart valve fibrosis, retraction, and clinically significant regurgitation in PD patients. While cabergoline has been used at much lower doses in patients with hyperprolactinemia, controversy persists as to whether it may cause heart valve disease in this situation. Cabergoline is also used in acromegaly at doses similar to those used in hyperprolactinemia. The case is reported of a female patient with acromegaly who had been taking low-dose (0.5 mg/day) cabergoline for one year, and presented with signs and symptoms of right-sided heart failure. Echocardiography revealed a thickened and retracted tricuspid valve associated with severe tricuspid regurgitation and enlargement of the right-heart chambers. The morphology of the tricuspid valve was typical for cabergoline-related valvulopathy. Cabergoline may not be totally safe even at lower doses, and close echocardiographic monitoring is recommended in patients receiving cabergoline treatment, regardless of the dose level employed.
authors.affiliation: Department of Cardiology, Gaziosmanpasa Hospital, Istanbul, Turkey. cemil_izgi@yahoo.com
authors.forename: Cemil
authors.initials: C
authors.lastname: Izgi
authors.forename: Hasan
authors.initials: H
authors.lastname: Feray
authors.forename: Cihan
authors.initials: C
authors.lastname: Cevik
authors.forename: Yelda
authors.initials: Y
authors.lastname: Saltan
authors.forename: Denyan
authors.initials: D
authors.lastname: Mansuroglu
authors.forename: Kenneth
authors.initials: K
authors.lastname: Nugent
mesh_terms: D000172:Acromegaly / Q000188:drug therapy*; D000077465:Cabergoline; D004232:Diuretics; D018618:Echocardiography, Doppler, Color; D004873:Ergolines / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D006333:Heart Failure / Q000139:chemically induced; D006727:Hormone Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy
chemical_list: D004232:Diuretics; D004873:Ergolines; D006727:Hormone Antagonists; D005665:Furosemide; D000077465:Cabergoline