Valvular heart disease in Parkinson's disease vs. controls: An echocardiographic study.
Identifieur interne : 001643 ( Ncbi/Curation ); précédent : 001642; suivant : 001644Valvular heart disease in Parkinson's disease vs. controls: An echocardiographic study.
Auteurs : Cecilia Peralta [Autriche] ; Elisabeth Wolf ; Hannes Alber ; Klaus Seppi ; Silvana Müller ; Sylvia Bösch ; Gregor K. Wenning ; Otmar Pachinger ; Werner Poewe [Autriche]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2006.
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (adverse effects), Antiparkinson Agents (therapeutic use), Echocardiography, Female, Heart Valve Diseases (epidemiology), Heart Valve Diseases (ultrasonography), Humans, Male, Middle Aged, Parkinson Disease (complications), Parkinson Disease (drug therapy), Parkinson Disease (ultrasonography).
- MESH :
- chemical , adverse effects : Antiparkinson Agents.
- chemical , therapeutic use : Antiparkinson Agents.
- complications : Parkinson Disease.
- drug therapy : Parkinson Disease.
- epidemiology : Heart Valve Diseases.
- ultrasonography : Heart Valve Diseases, Parkinson Disease.
- Aged, Echocardiography, Female, Humans, Male, Middle Aged.
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.
DOI: 10.1002/mds.20887
PubMed: 16622856
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pubmed:16622856Le document en format XML
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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.</div>
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