title: No clinically significant valvular regurgitation in long-term cabergoline treatment for prolactinoma.
abstract: BACKGROUND
  An association between treatment for Parkinson's disease with certain dopaminergic drugs and development of cardiac valve impairment has been reported. Recent studies in hyperprolactinaemic patients treated with cabergoline (CAB) have shown either no significant findings or mild tricuspid regurgitation.
  
  
  OBJECTIVE
  To determine the prevalence of cardiac valve dysfunction in patients with hyperprolactinaemic conditions chronically treated with CAB or bromocriptine (BR).
  
  
  METHODS
  Retrospective, multicentric, cross-sectional study of cases vs controls.
  
  
  METHODS
  Eighty-three hyperprolactinaemic patients (15 men, 68 women aged 16·7-63 years; 64% microprolactinomas, 28% macroprolactinomas and 8% other etiologies) from three Spanish university hospitals chronically treated with BR (14-562·5 weeks, cumulative dose 5603 ± 7729 mg) or CAB (12-765 weeks, 217·4 ± 306·6 mg).
  
  
  METHODS
  Transthoracic echocardiographic assessment of valvular regurgitation and thickening, mitral valve tenting area and left-ventricular ejection fraction from 83 patients were compared with results from 58 age- and sex-matched controls and correlated with cumulative doses of dopaminergic drugs.
  
  
  RESULTS
  No significant differences in valvular regurgitation, valve thickness or any other echocardiographic parameter were observed between controls and patients, except for 15 patients in the higher quartile of CAB cumulative dose (>180 mg), with increased prevalence of mild tricuspid regurgitation (6/15, 40% vs 8/58, 13·8%, P = 0·024; OR 4·1; 1·1-14·9). High BR cumulative dose was associated with no significant findings.
  
  
  CONCLUSIONS
  No increased valvular involvement was found after long-term dopaminergic therapy for hyperprolactinaemia except for a significant increase in mild tricuspid regurgitation associated with high cumulative doses of CAB; BR seems spared from this adverse effect, although the low number of cases limits this analysis. Cumulative dose registry and long-term studies are warranted to definitely clarify this item.
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain. halperin@clinic.ub.es
authors.forename: Irene
authors.initials: I
authors.lastname: Halperin
authors.forename: Javier
authors.initials: J
authors.lastname: Aller
authors.forename: César
authors.initials: C
authors.lastname: Varela
authors.forename: Mireia
authors.initials: M
authors.lastname: Mora
authors.forename: Ainhoa
authors.initials: A
authors.lastname: Abad
authors.forename: Ada
authors.initials: A
authors.lastname: Doltra
authors.forename: Alicia Estrella
authors.initials: AE
authors.lastname: Santos
authors.forename: Esther
authors.initials: E
authors.lastname: Batista
authors.forename: Pablo
authors.initials: P
authors.lastname: García-Pavía
authors.forename: Marta
authors.initials: M
authors.lastname: Sitges
authors.forename: Jesús G
authors.initials: JG
authors.lastname: Mirelis
authors.forename: Tomás
authors.initials: T
authors.lastname: Lucas
authors.forename: Manel
authors.initials: M
authors.lastname: Puig-Domingo
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001971:Bromocriptine / Q000009:adverse effects / Q000627:therapeutic use; D000077465:Cabergoline; D003430:Cross-Sectional Studies; D004452:Echocardiography; D004873:Ergolines / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015175:Prolactinoma / Q000188:drug therapy*; D012189:Retrospective Studies; D014262:Tricuspid Valve Insufficiency / Q000139:chemically induced*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D004873:Ergolines; D001971:Bromocriptine; D000077465:Cabergoline