“…A recent nested case-control study (12) has shown in a large series that treatment with DA is associated with an increased risk of clinically relevant valve disease (CRVD) in PD but not in hyperprolactinemic patients. Over the past 5 years, 15 independent studies (13,14,15,16,17,18,19,20,21,22,23,24,25,26,27) (Table 1) have investigated the effects of CAB on the development of CRVD in patients with prolactinomas. Overall, these studies have reported a median CRVD rate of w4%, with the prevalence of CRVD ranging from 54% (13), 40% (24), 15% (17) to 0% (15,16,19,21) and valvulopathy being assessed according to the International Guidelines suggested by the American Society of Echocardiography (28,29) in all studies and also according to the European Association of Echocardiography (30,31) in ten studies (13,16,17,18,20,22,23,25,26,27).…”