ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 S30.5

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

Annamaria Colao1, Maurizio Galderisi2, Antonella Di Sarno1, Moira Pardo2, Maria Gaccione1, Marianna D’Andrea1, Rosario Pivonello1, Ermelinda Guerra1, Giuseppe Lerro2 & Gaetano Lombardi1

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.