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, casecontrol, prospective.
Patients: Fifty patients (44 women, 6 men) and 50 sex- and age-matched control subjects.
Intervention: In the patients last cabergoline dose was 0.57.0 mg/week (1.3±1.3 mg/week): <1 mg/week in 44%, 13 mg/week in 46% and >3 mg/week in 10%. Treatment duration was 1260 months in 32% and >60 months in 68%. The cumulative (mg×months of treatment) dose of cabergoline ranged 321938 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.
03 - 07 May 2008
European Society of Endocrinology