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Endocrine Abstracts (2014) 34 CMW4.2 | DOI: 10.1530/endoabs.34.CMW4.2

QMUL, London, UK.


Concern exists in the literature that the long-term use of ergot-derived dopamine agonists (DAs) may be associated with the development of clinically-significant cardiac valvulopathy. This has arisen largely by extrapolation from experience with high doses of these drugs given to patients with degenerative neurological conditions and it has led to regulatory authority recommendations to arrange regular screening echocardiograms for patients receiving much lower doses of these drugs for hyperprolactinaemic states. Many physicians experienced in the management of pituitary disease were surprised at those recommendations and adherence to the suggested protocols has been heterogeneous across the UK.

Addressing this issue by means of clinical research studies performed within endocrine clinics is not straightforward for a number of reasons. First, population control data on the incidence of cardiac valvulopathy in healthy individuals are surprisingly hard to find. Second, many of the single centre reports of screening echocardiograms performed in patients with lactotroph pituitary tumours treated with DA have involved sample sizes that make meaningful statistical analysis difficult. Third, echocardiography is a technique that relies on subjective as well as objective assessment and it is well-established in the field that knowledge of the clinical background and medication history can influence the findings of even experienced cardiac technicians.

This talk will summarise the published evidence on this important clinical practice point and attempt to draw useful, pragmatic conclusions for physicians practising in the field.

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