Valvular heart disease in Parkinson's disease patients treated with dopamine agonists: a reader-blinded monocenter echocardiography study.
Identifieur interne : 002485 ( PubMed/Checkpoint ); précédent : 002484; suivant : 002486Valvular heart disease in Parkinson's disease patients treated with dopamine agonists: a reader-blinded monocenter echocardiography study.
Auteurs : Susann Junghanns [Allemagne] ; Joerg T. Fuhrmann ; Gregor Simonis ; Christian Oelwein ; Rainer Koch ; Ruth H. Strasser ; Heinz Reichmann ; Alexander StorchSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2007.
English descriptors
- KwdEn :
- Benzothiazoles (therapeutic use), Dopamine Agonists (therapeutic use), Double-Blind Method, Echocardiography (instrumentation), Ergolines (therapeutic use), Female, Fibrosis (epidemiology), Fibrosis (pathology), Heart Valve Diseases (diagnosis), Heart Valve Diseases (epidemiology), Heart Valve Diseases (pathology), Humans, Hypertrophy, Left Ventricular (diagnosis), Hypertrophy, Left Ventricular (epidemiology), Indoles (therapeutic use), Male, Middle Aged, Mitral Valve Insufficiency (diagnosis), Mitral Valve Insufficiency (epidemiology), Parkinson Disease (drug therapy), Parkinson Disease (epidemiology), Pergolide (therapeutic use), Severity of Illness Index, Tricuspid Valve Insufficiency (diagnosis), Tricuspid Valve Insufficiency (epidemiology).
- MESH :
- chemical , therapeutic use : Benzothiazoles, Dopamine Agonists, Ergolines, Indoles, Pergolide.
- diagnosis : Heart Valve Diseases, Hypertrophy, Left Ventricular, Mitral Valve Insufficiency, Tricuspid Valve Insufficiency.
- drug therapy : Parkinson Disease.
- epidemiology : Fibrosis, Heart Valve Diseases, Hypertrophy, Left Ventricular, Mitral Valve Insufficiency, Parkinson Disease, Tricuspid Valve Insufficiency.
- instrumentation : Echocardiography.
- pathology : Fibrosis, Heart Valve Diseases.
- Double-Blind Method, Female, Humans, Male, Middle Aged, Severity of Illness Index.
Abstract
Fibrotic valvular heart disease (VHD) has been reported in association with ergot dopamine agonists (DAs), but the current database is insufficient regarding clinical relevance and comparison to data on non-ergot DAs. We evaluated the effects of four DAs (pergolide, cabergoline, ropinirole, pramipexole) on morphology and function of heart valves in patients with Parkinson's disease (PD) to determine the frequency and clinical relevance of DA-induced VHD. A total of 85 patients treated with ergot or non-ergot DAs and 38 age-matched controls were evaluated by transthoracic echocardiography. Valvular pathology was assessed by established criteria of valvular regurgitation and a VHD scoring system. Both grading systems revealed increased frequency of VHD in ergot DA patients compared to both non-ergot DA patients and controls with 22% of ergot DA patients having moderate VHD versus 3% of non-ergot DA patients and none of controls (P = 0.001). We did not find correlations of echocardiographic findings with duration/cumulative dose of treatment, age, or vascular risk factors. Our data suggest that ergot DAs are associated with higher prevalence of VHD compared to non-ergot DAs and controls. Standard echocardiography seems sufficient to detect VHD in PD patients treated with DAs.
DOI: 10.1002/mds.21225
PubMed: 17094087
Affiliations:
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<term>Echocardiography (instrumentation)</term>
<term>Ergolines (therapeutic use)</term>
<term>Female</term>
<term>Fibrosis (epidemiology)</term>
<term>Fibrosis (pathology)</term>
<term>Heart Valve Diseases (diagnosis)</term>
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<front><div type="abstract" xml:lang="en">Fibrotic valvular heart disease (VHD) has been reported in association with ergot dopamine agonists (DAs), but the current database is insufficient regarding clinical relevance and comparison to data on non-ergot DAs. We evaluated the effects of four DAs (pergolide, cabergoline, ropinirole, pramipexole) on morphology and function of heart valves in patients with Parkinson's disease (PD) to determine the frequency and clinical relevance of DA-induced VHD. A total of 85 patients treated with ergot or non-ergot DAs and 38 age-matched controls were evaluated by transthoracic echocardiography. Valvular pathology was assessed by established criteria of valvular regurgitation and a VHD scoring system. Both grading systems revealed increased frequency of VHD in ergot DA patients compared to both non-ergot DA patients and controls with 22% of ergot DA patients having moderate VHD versus 3% of non-ergot DA patients and none of controls (P = 0.001). We did not find correlations of echocardiographic findings with duration/cumulative dose of treatment, age, or vascular risk factors. Our data suggest that ergot DAs are associated with higher prevalence of VHD compared to non-ergot DAs and controls. Standard echocardiography seems sufficient to detect VHD in PD patients treated with DAs.</div>
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<Abstract><AbstractText>Fibrotic valvular heart disease (VHD) has been reported in association with ergot dopamine agonists (DAs), but the current database is insufficient regarding clinical relevance and comparison to data on non-ergot DAs. We evaluated the effects of four DAs (pergolide, cabergoline, ropinirole, pramipexole) on morphology and function of heart valves in patients with Parkinson's disease (PD) to determine the frequency and clinical relevance of DA-induced VHD. A total of 85 patients treated with ergot or non-ergot DAs and 38 age-matched controls were evaluated by transthoracic echocardiography. Valvular pathology was assessed by established criteria of valvular regurgitation and a VHD scoring system. Both grading systems revealed increased frequency of VHD in ergot DA patients compared to both non-ergot DA patients and controls with 22% of ergot DA patients having moderate VHD versus 3% of non-ergot DA patients and none of controls (P = 0.001). We did not find correlations of echocardiographic findings with duration/cumulative dose of treatment, age, or vascular risk factors. Our data suggest that ergot DAs are associated with higher prevalence of VHD compared to non-ergot DAs and controls. Standard echocardiography seems sufficient to detect VHD in PD patients treated with DAs.</AbstractText>
<CopyrightInformation>(c) 2006 Movement Disorder Society.</CopyrightInformation>
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