Valvular heart disease in Parkinson's disease vs. controls: An echocardiographic study
Identifieur interne : 001789 ( Istex/Corpus ); précédent : 001788; suivant : 001790Valvular heart disease in Parkinson's disease vs. controls: An echocardiographic study
Auteurs : Cecilia Peralta ; Elisabeth Wolf ; Hannes Alber ; Klaus Seppi ; Silvana Müller ; Sylvia Bösch ; Gregor K. Wenning ; Otmar Pachinger ; Werner PoeweSource :
- Movement Disorders [ 0885-3185 ] ; 2006-08.
English descriptors
Abstract
Restrictive valvulopathy has been reported in association with dopamine agonist therapy in parkinsonian patients. The majority of reports have been related to pergolide, but anecdotal cases following treatment with bromocriptine or cabergoline have also been presented. It is presently unclear whether the potential induction of restrictive cardiac valvulopathy is a class effect of all dopamine agonists or if there is a differential risk between ergot and nonergot compounds. In this study, the frequency of a valvular regurgitation as assessed by routine transthoracic echocardiography was compared between 75 patients with Parkinson's disease (PD) treated with pergolide (n = 29), cabergoline (n = 13), pramipexole or ropinirole (n = 33), and 49 age‐matched nonparkinsonian controls. The exposure to pergolide and cabergoline was associated with higher frequencies of valvular regurgitation grades 2 and 3 (31% and 47%) compared with age‐matched controls (13%), while there was no increase of valvular regurgitation grades 2 and 3 in patients treated with nonergot compounds (10%). Evidence for restrictive valvulopathy was found in one patient treated with pergolide and cabergoline each. While this study shows similarly increased frequencies of valvular regurgitation in patients treated with the ergot agonists pergolide and cabergoline in comparison to both normal controls and patients treated with nonergot agonists, evidence for restrictive valvulopathy was only found in two cases. These results highlight the need for further prospective studies of the prevalence and underlying mechanisms of cardiac valvulopathy in PD patients treated with different dopamine agonists. © 2006 Movement Disorder Society
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DOI: 10.1002/mds.20887
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<front><div type="abstract" xml:lang="en">Restrictive valvulopathy has been reported in association with dopamine agonist therapy in parkinsonian patients. The majority of reports have been related to pergolide, but anecdotal cases following treatment with bromocriptine or cabergoline have also been presented. It is presently unclear whether the potential induction of restrictive cardiac valvulopathy is a class effect of all dopamine agonists or if there is a differential risk between ergot and nonergot compounds. In this study, the frequency of a valvular regurgitation as assessed by routine transthoracic echocardiography was compared between 75 patients with Parkinson's disease (PD) treated with pergolide (n = 29), cabergoline (n = 13), pramipexole or ropinirole (n = 33), and 49 age‐matched nonparkinsonian controls. The exposure to pergolide and cabergoline was associated with higher frequencies of valvular regurgitation grades 2 and 3 (31% and 47%) compared with age‐matched controls (13%), while there was no increase of valvular regurgitation grades 2 and 3 in patients treated with nonergot compounds (10%). Evidence for restrictive valvulopathy was found in one patient treated with pergolide and cabergoline each. While this study shows similarly increased frequencies of valvular regurgitation in patients treated with the ergot agonists pergolide and cabergoline in comparison to both normal controls and patients treated with nonergot agonists, evidence for restrictive valvulopathy was only found in two cases. These results highlight the need for further prospective studies of the prevalence and underlying mechanisms of cardiac valvulopathy in PD patients treated with different dopamine agonists. © 2006 Movement Disorder Society</div>
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<correspondenceTo>Department of Neurology, Innsbruck Medical University, Anichstrasse 35, A‐6020 Innsbruck, Austria</correspondenceTo>
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<titleGroup><title type="main" xml:lang="en">Valvular heart disease in Parkinson's disease vs. controls: An echocardiographic study</title>
<title type="short" xml:lang="en">Valvular Heart Disease</title>
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<creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Cecilia</givenNames>
<familyName>Peralta</familyName>
<degrees>MD</degrees>
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<creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Elisabeth</givenNames>
<familyName>Wolf</familyName>
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<creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Klaus</givenNames>
<familyName>Seppi</familyName>
<degrees>MD</degrees>
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<creator xml:id="au5" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Silvana</givenNames>
<familyName>Müller</familyName>
<degrees>MD</degrees>
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<creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Sylvia</givenNames>
<familyName>Bösch</familyName>
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<creator xml:id="au7" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Gregor K.</givenNames>
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<creator xml:id="au8" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Otmar</givenNames>
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<keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword>
<keyword xml:id="kwd2">dopamine agonist</keyword>
<keyword xml:id="kwd3">valvular heart disease</keyword>
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<abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title>
<p>Restrictive valvulopathy has been reported in association with dopamine agonist therapy in parkinsonian patients. The majority of reports have been related to pergolide, but anecdotal cases following treatment with bromocriptine or cabergoline have also been presented. It is presently unclear whether the potential induction of restrictive cardiac valvulopathy is a class effect of all dopamine agonists or if there is a differential risk between ergot and nonergot compounds. In this study, the frequency of a valvular regurgitation as assessed by routine transthoracic echocardiography was compared between 75 patients with Parkinson's disease (PD) treated with pergolide (n = 29), cabergoline (n = 13), pramipexole or ropinirole (n = 33), and 49 age‐matched nonparkinsonian controls. The exposure to pergolide and cabergoline was associated with higher frequencies of valvular regurgitation grades 2 and 3 (31% and 47%) compared with age‐matched controls (13%), while there was no increase of valvular regurgitation grades 2 and 3 in patients treated with nonergot compounds (10%). Evidence for restrictive valvulopathy was found in one patient treated with pergolide and cabergoline each. While this study shows similarly increased frequencies of valvular regurgitation in patients treated with the ergot agonists pergolide and cabergoline in comparison to both normal controls and patients treated with nonergot agonists, evidence for restrictive valvulopathy was only found in two cases. These results highlight the need for further prospective studies of the prevalence and underlying mechanisms of cardiac valvulopathy in PD patients treated with different dopamine agonists. © 2006 Movement Disorder Society</p>
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<titleInfo type="abbreviated" lang="en"><title>Valvular Heart Disease</title>
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<name type="personal"><namePart type="given">Hannes</namePart>
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<name type="personal"><namePart type="given">Klaus</namePart>
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<name type="personal"><namePart type="given">Silvana</namePart>
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<abstract lang="en">Restrictive valvulopathy has been reported in association with dopamine agonist therapy in parkinsonian patients. The majority of reports have been related to pergolide, but anecdotal cases following treatment with bromocriptine or cabergoline have also been presented. It is presently unclear whether the potential induction of restrictive cardiac valvulopathy is a class effect of all dopamine agonists or if there is a differential risk between ergot and nonergot compounds. In this study, the frequency of a valvular regurgitation as assessed by routine transthoracic echocardiography was compared between 75 patients with Parkinson's disease (PD) treated with pergolide (n = 29), cabergoline (n = 13), pramipexole or ropinirole (n = 33), and 49 age‐matched nonparkinsonian controls. The exposure to pergolide and cabergoline was associated with higher frequencies of valvular regurgitation grades 2 and 3 (31% and 47%) compared with age‐matched controls (13%), while there was no increase of valvular regurgitation grades 2 and 3 in patients treated with nonergot compounds (10%). Evidence for restrictive valvulopathy was found in one patient treated with pergolide and cabergoline each. While this study shows similarly increased frequencies of valvular regurgitation in patients treated with the ergot agonists pergolide and cabergoline in comparison to both normal controls and patients treated with nonergot agonists, evidence for restrictive valvulopathy was only found in two cases. These results highlight the need for further prospective studies of the prevalence and underlying mechanisms of cardiac valvulopathy in PD patients treated with different dopamine agonists. © 2006 Movement Disorder Society</abstract>
<subject lang="en"><genre>Keywords</genre>
<topic>Parkinson's disease</topic>
<topic>dopamine agonist</topic>
<topic>valvular heart disease</topic>
<topic>echocardiography</topic>
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<relatedItem type="host"><titleInfo><title>Movement Disorders</title>
<subTitle>Official Journal of the Movement Disorder Society</subTitle>
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<identifier type="ISSN">0885-3185</identifier>
<identifier type="eISSN">1531-8257</identifier>
<identifier type="DOI">10.1002/(ISSN)1531-8257</identifier>
<identifier type="PublisherID">MDS</identifier>
<part><date>2006</date>
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<number>21</number>
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<number>8</number>
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