Endocrine Abstracts (2008) 15 P89

Study on dopamine agonists and valvular heart disease in patients with acromegaly

Vidhu Nayyar1, Miles J Levy1, Joan E Davies2 & Trevor A Howlett1

1Departments of Diabetes and Endocrinology; 2Cardiorespiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.

Introduction: Dopamine Agonists are important in the management of endocrine disorders such as acromegaly and hyperprolactinaemia. Recent studies have shown that Cabergoline used in high doses to treat Parkinson’s disease is associated with cardiac valve fibrosis.

Methods: We identified patients on long term high-dose cabergoline for the management of acromegaly. The following data was analysed: demographic data, duration of treatment, cumulative dose of cabergoline in mg, growth hormones and IGF1 levels pre and post treatment, pulmonary function tests were performed and all patients had transthoracic echocardiograms performed by a single consultant cardiologist.

Results: Ten patients (5 female; 6 Caucasian, 4 Indo-Asian), Median age 56±13.6 years, median duration on cabergoline 114.3±47.1 months (range 18.7–158.9 months). The median cumulative dose was 1741±717.3 mg. Median dose/day 0.5 mg (range 0.14–0.5 mg). The median growth hormone (pre versus post) 56.3±56.5 vs 5±1.30 min/l. Median IGF1 (pre versus post) 781±769.7 ug/l versus 320.5±75.8 ug/l. Seven patients had micro adenomas and 3 macro adenomas. All ten patients had transthoracic echocardiograms of which nine were reported showing normal valve function, one patient was reported as having trivial Aortic regurgitation and mitral regurgitation due to degenerative disease. The spirommetry results revealed 3 patients were excluded (2 due to pre-existing lung disease and 1 due to severe kyphoscoliosis) 3 patients FEVi/FVC ratio’s were within the normal range and 4 patients showed mild obstructive changes of which 2 were smokers.

Conclusion: Although the numbers were small this study showed that there was no risk associated with cardiac valve regurgitation.

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