Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2008) 16 S30.5

ECE2008 Symposia Clinical highlights (6 abstracts)

Increased prevalence of tricuspid regurgitation in patients with prolactinomas chronically treated with cabergoline: dose and treatment duration effect

Annamaria Colao 1 , Maurizio Galderisi 2 , Antonella Di Sarno 1 , Moira Pardo 2 , Maria Gaccione 1 , Marianna D’Andrea 1 , Rosario Pivonello 1 , Ermelinda Guerra 1 , Giuseppe Lerro 2 & Gaetano Lombardi 1


1Department of Molecular and Clinical Endocrinology and Oncology, Section of Endocrinology, Federico II University of Naples, Naples, Italy; 2Department of Clinical and Experimental Medicine, Section of Cardioangiology, Federico II University of Naples, Naples, Italy.


Background: Cabergoline, a dopamine receptor-2 agonist, used to treat prolactinomas was associated with increased risk of cardiac valve disease.

Objective: To evaluate prevalence of cardiac valve regurgitation in patients with prolactinomas treated with cabergoline.

Design: Open, case–control, prospective.

Patients: Fifty patients (44 women, 6 men) and 50 sex- and age-matched control subjects.

Intervention: In the patients last cabergoline dose was 0.5–7.0 mg/week (1.3±1.3 mg/week): <1 mg/week in 44%, 1–3 mg/week in 46% and >3 mg/week in 10%. Treatment duration was 12–60 months in 32% and >60 months in 68%. The cumulative (mg×months of treatment) dose of cabergoline ranged 32–1938 mg (median 280 mg).

Measurements: Valve regurgitation was assessed according to the recommendations of the American Society of Echocardiography.

Results: Prevalence of mild regurgitation of mitral (22% vs 12%, P=0.29), aortic (4% vs 2%, P=1), tricuspid (30% vs 42%, P=0.29) or pulmonic (12% vs 6%, P=0.48) valves was similar in patients and controls while moderate tricuspid regurgitation was higher in the patients (54% vs 18%, P<0.001). Moderate tricuspid regurgitation was more frequent in patients receiving a cumulative dose above the median (36% vs 72%, P=0.023) than in dose receiving a lower dose, who had a prevalence similar to controls (36% vs 18%, P=0.15).

Conclusion: Moderate tricuspid regurgitation is more frequent in patients taking cabergoline than in control subjects. Mostly in patients treated at higher cumulative doses. A complete echocardiographic assessment is indicated in patients treated long-term with cabergoline, particularly in those requiring elevated doses.

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