Dopamine agonists and cardiac valvulopathy in Parkinson disease

Yamamoto, Mitsutoshi; Uesugi, Tadahisa; Nakayama, Takeo

doi:10.1212/01.wnl.0000238508.68593.1d

Cited by 104 publications

(72 citation statements)

References 20 publications

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“…In our study, despite the similarity of mean daily doses of cabergoline, duration of therapy and therefore cumulative dose was higher compared to other studies (15). Moreover composite regurgitation score was higher in patients using cabergoline which was associated both with duration and cumulative dose of cabergoline therapy as in line with previous studies (15,18). In addition to valvular regurgitation, morphologic features including leaflet and subvalvular apparatus thickening were more prevalent in patient using cabergoline similar to previous studies (19).…”

Section: Discussionsupporting

confidence: 84%

Evaluation of the valvular and biventricular functions in Parkinson patients using ergotamine-derived dopamine agonist: an observational study

Özer

Yorgun²,

Canpolat³

et al. 2014

Anadolu Kardiyol Derg

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Objective: In this study, we aimed to evaluate the impact of cabergoline use in patients with Parkinson's disease on valvular and biventricular functions. Methods: In this observational cohort study, patients with Parkinson disease were divided into 2 groups as 34 patients (41.2% female, age; 57.4±15.3 years) using cabergoline (Group 1) and 42 patients (61.9% female, age; 53.7±7.1 years) not using cabergoline (Group 2). In addition to conventional echocardiography and diastolic functions, tissue Doppler imaging was used to evaluate both global and regional systolic -diastolic functions. Correlations were assessed using Pearson correlation coefficient for normally distributed variables. Results: In group 1 patients cabergoline was used for 7.7±5.1 years and mean and cumulative cabergoline dose were 3.3±1.1 mg and 9.8±7.0 g respectively. Left ventricular systolic functions and tissue Doppler measurements of septal and lateral mitral annulus and right ventricular systolic and diastolic velocities were similar between groups. Mitral valve tenting area was significantly higher in patients using cabergoline (p=0.007). The association between cumulative cabergoline dose and diastolic functions was also evaluated which revealed that among diastolic function parameters, Epeak (r=0.253, p=0.042), E/A (r=0.256, p=0.026) and DT (r=-0.382, p=0.001) were correlated with cumulative cabergoline dose. There was a positive correlation between cumulative cabergoline dose and duration of cabergoline therapy with composite regurgitation score (r=0.435, p<0.001; r=0.485, p<0.001, respectively). Conclusion: Our findings indicated that despite the well known effects of cabergoline on valvular functions, we did not observe any alteration in systolic functions, but diastolic functions which was associated with cumulative cabergoline dose in patients with Parkinson's disease.

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Section: Discussionsupporting

confidence: 84%

Evaluation of the valvular and biventricular functions in Parkinson patients using ergotamine-derived dopamine agonist: an observational study

Özer

Yorgun²,

Canpolat³

et al. 2014

Anadolu Kardiyol Derg

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“…Several cross-sectional studies have demonstrated a significantly increased risk of valvular fibrosis in Parkinson's patients treated with the ergot-derived dopamine agonists (DAs) pergolide and cabergoline (1,2,3,4,5,6). Extensive research over the last decade has highlighted the crucial role of 5-hydroxytryptamine 2B receptors (HTR2B) in the pathogenesis of this fibrotic valvular heart disease (FVHD) (7).…”

Section: Introductionmentioning

confidence: 99%

Increased prevalence of subclinical cardiac valve fibrosis in patients with prolactinomas on long-term bromocriptine and cabergoline treatment

Еленкова¹,

Shabani

Kalinov

et al. 2012

European Journal of Endocrinology

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Background: In contrast to cabergoline, evidence-based information about a possible profibrotic effect of bromocriptine in prolactinoma patients is extremely limited. Objective: To assess the prevalence of valvular lesions among patients on long-term bromocriptine or cabergoline therapy. Design: Case-control study. Methods: A transthoracic echocardiographic evaluation was performed in 334 subjects divided into four groups: 103 cabergoline treated, 55 bromocriptine treated, 74 naïve patients, and 102 controls. Results: Clinically relevant valve regurgitations were equally prevalent in all investigated groups whereas subclinical valve fibrosis was significantly more frequent in both bromocriptine-and cabergoline-treated patients (40 vs 43.6 vs 21.6 vs 23.5%; PZ0.004). The odds ratio (OR) for developing valvular fibrosis was 2.27 (95% CI 1.17-4.41; PZ0.016) for cabergoline and 2.66 (95% CI 1.22-5.78; PZ0.014) for bromocriptine groups compared with subjects not exposed to dopamine agonists (DAs). A significantly higher pulmonary arterial pressure corresponding to the longer treatment duration was observed among patients taking bromocriptine compared with cabergolinetreated subjects. Conclusions: Long-term treatment with cabergoline and bromocriptine seems not to be associated with an increased risk of clinically significant valve disease but possible subclinical lesions should be expected. An echocardiographic examination is recommended at the beginning and periodically during therapy with DAs acting as full or partial agonists of 5-hydroxytrytamine 2B receptors (cabergoline and bromocriptine). Bromocriptine seems not to be a safe alternative for patients receiving cabergoline treatment who have preexisting or diagnosed abnormalities suggesting valvular, interstitial myocardial, or pulmonary fibrosis. Further studies are needed to investigate the possible impact of DA treatment on pulmonary arterial pressure.

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“…Long-term treatment of Parkinson's disease with the dopamine agonists (DAs) pergolide and cabergoline has been established to be associated with a significantly increased risk of developing fibrotic valvular heart disease (FVHD) (1,2,3,4). The process is triggered by the activation of the serotonin receptors (5HT 2b ), which are highly expressed in cardiac valves (5,6,7).…”

Section: Introductionmentioning

confidence: 99%

Transforming growth factor β1 is not a reliable biomarker for valvular fibrosis but could be a potential serum marker for invasiveness of prolactinomas (pilot study)

Еленкова¹,

Atanassova²,

Кirilov³

et al. 2013

European Journal of Endocrinology

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Background: Transforming growth factor b1 (TGFb1) signaling pathway is crucial for both human fibrogenesis and tumorigenesis. Objective: This study aimed to investigate the usefulness of TGFb1 and matrix metalloproteinase 2 (MMP2) as potential circulating markers for fibrotic valvular heart disease (FVHD) and invasiveness as well as of Fetuin A as a marker for calcification in patients with prolactinomas. Design: The study population consisted of 147 subjects divided into four groups: 30 dopamine agonist (DA)-treated prolactinoma patients with proven FVHD and three control groups with normal echocardiograms: 43 DA-treated patients, 26 naïve patients, and 48 healthy subjects. Results: We observed significantly higher serum TGFb1 levels in all three patient groups than in the healthy subjects (21.4G8.86 vs 19.1G9.03 vs 20.7G11.5 vs 15.8G7.2 ng/ml; PZ0.032). Moreover, TGFb1 levels were significantly higher in patients with macroprolactinomas and invasive prolactinomas than in those with microprolactinomas and noninvasive tumors respectively. In addition, a strong positive linear relationship between TGFb1 levels and invasiveness score (rZ0.924; P!0.001) and a moderate correlation between TGFb1 levels and tumor volume (rZ0.546; P!0.002) were observed in patients with invasive prolactinomas. By contrast, prolactin (PRL) levels exhibited a better correlation with tumor volume (rZ0.721; P!0.001) than with invasiveness score (rZ0.436; P!0.020). No significant difference was observed in Fetuin A levels between patients with FVHD and healthy controls. Results concerning MMP2 were unclear. Conclusions: TGFb1, MMP2, and Fetuin A are not reliable biomarkers for valvular fibrosis and calcification in DA-treated patients with prolactinomas, but TGFb1 may represent a useful serum marker for tumor invasiveness. The simultaneous determination of TGFb1 and PRL levels could improve the noninvasive assessment of prolactinoma behavior.

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Dopamine agonists and cardiac valvulopathy in Parkinson disease

Abstract: The frequency of valvulopathy was significantly increased in the cabergoline group. Our results indicate that high cumulative dose and long-term treatment with cabergoline are risk factors for valvulopathy in patients with Parkinson disease.

Cited by 104 publications

References 20 publications

Evaluation of the valvular and biventricular functions in Parkinson patients using ergotamine-derived dopamine agonist: an observational study

Evaluation of the valvular and biventricular functions in Parkinson patients using ergotamine-derived dopamine agonist: an observational study

Increased prevalence of subclinical cardiac valve fibrosis in patients with prolactinomas on long-term bromocriptine and cabergoline treatment

Transforming growth factor β1 is not a reliable biomarker for valvular fibrosis but could be a potential serum marker for invasiveness of prolactinomas (pilot study)

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