Objective: Treatment with ergot-derived dopamine agonists, pergolide and cabergoline, has been associated with an increased frequency of valvular heart disease in Parkinsons disease. The aim of the present study was to assess the prevalence of valvular heart disease in patients treated with dopamine agonists for prolactinomas.
Design: Cross-sectional study.
Patients: We performed conventional two-dimensional and Doppler echocardiography in 78 consecutive patients with prolactinoma (mean age 47±1.4 years, 26% male, 33% macroprolactinoma) treated with dopamine agonists for at least 1 year (mean 8±0.6 years) and 78 control subjects (matched for age, gender, body surface, and left ventricular systolic function). Patients were classified according to treatment: patients treated with ergot-derived dopamine agonists (cabergoline, bromocriptine, and terguride) (group 1: n=57), and patients treated with non-ergot derived dopamine agonist (quinagolide) or other treatment modalities than dopamine agonists (group 2: n=21).
Results: Clinically relevant valvular heart disease was present in 12% (9 of 78) of patients vs. 17% (13 of 78) of controls (P=0.141), and in 14% (8 of 57) of patients treated with ergot-derived dopamine agonists vs. 5% (1 of 21) of patients treated with non-ergot derived dopamine agonists or no dopamine agonist (P=0.483). Mild regurgitation of the tricuspid valve was significantly more present in patients compared to controls (41% vs. 26%, P=0.042).
Conclusion: Long-term dopamine agonist therapy in patients with prolactinoma is not associated with increased prevalence of clinically relevant valvular heart disease.
03 - 07 May 2008
European Society of Endocrinology