Valvular heart disease in Parkinson's disease vs. Controls : An echocardiographic study
Identifieur interne : 004941 ( Main/Merge ); précédent : 004940; suivant : 004942Valvular heart disease in Parkinson's disease vs. Controls : An echocardiographic study
Auteurs : Cecilia Peralta [Autriche] ; Elisabeth Wolf [Autriche] ; Hannes Alber [Autriche] ; Klaus Seppi [Autriche] ; Silvana Müller [Autriche] ; Sylvia Bosch [Autriche] ; Gregor K. Wenning [Autriche] ; Otmar Pachinger [Autriche] ; Werner Poewe [Autriche]Source :
- Movement disorders [ 0885-3185 ] ; 2006.
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- Pascal (Inist)
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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.
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Wenning</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, Innsbruck Medical University</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Pachinger, Otmar" sort="Pachinger, Otmar" uniqKey="Pachinger O" first="Otmar" last="Pachinger">Otmar Pachinger</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Cardiology, Innsbruck Medical University</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, Innsbruck Medical University</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Innsbruck</wicri:noRegion><placeName><settlement type="city">Innsbruck</settlement><region nuts="2" type="region">Tyrol (Land)</region></placeName><orgName type="university">Université de médecine d'Innsbruck</orgName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cardiac valvular disease</term><term>Dopamine agonist</term><term>Echocardiography</term><term>Nervous system diseases</term><term>Parkinson disease</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Cardiopathie valvulaire</term><term>Parkinson maladie</term><term>Echocardiographie</term><term>Stimulant dopaminergique</term></keywords></textClass></profileDesc></teiHeader><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.</div></front></TEI><affiliations><list><country><li>Autriche</li></country><region><li>Tyrol (Land)</li></region><settlement><li>Innsbruck</li></settlement><orgName><li>Université de médecine d'Innsbruck</li></orgName></list><tree><country name="Autriche"><noRegion><name sortKey="Peralta, Cecilia" sort="Peralta, Cecilia" uniqKey="Peralta C" first="Cecilia" last="Peralta">Cecilia Peralta</name></noRegion><name sortKey="Alber, Hannes" sort="Alber, Hannes" uniqKey="Alber H" first="Hannes" last="Alber">Hannes Alber</name><name sortKey="Bosch, Sylvia" sort="Bosch, Sylvia" uniqKey="Bosch S" first="Sylvia" last="Bosch">Sylvia Bosch</name><name sortKey="Muller, Silvana" sort="Muller, Silvana" uniqKey="Muller S" first="Silvana" last="Müller">Silvana Müller</name><name sortKey="Pachinger, Otmar" sort="Pachinger, Otmar" uniqKey="Pachinger O" first="Otmar" last="Pachinger">Otmar Pachinger</name><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><name sortKey="Seppi, Klaus" sort="Seppi, Klaus" uniqKey="Seppi K" first="Klaus" last="Seppi">Klaus Seppi</name><name sortKey="Wenning, Gregor K" sort="Wenning, Gregor K" uniqKey="Wenning G" first="Gregor K." last="Wenning">Gregor K. Wenning</name><name sortKey="Wolf, Elisabeth" sort="Wolf, Elisabeth" uniqKey="Wolf E" first="Elisabeth" last="Wolf">Elisabeth Wolf</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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