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Arch Neurol. 2007 Mar;64(3):377-80.

Cardiac valve regurgitation with pergolide compared with nonergot agonists in Parkinson disease.

Author information

1
Department of Neurology and Division of Cardiology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-9036, USA. richard.dewey@utsouthwestern.edu

Abstract

BACKGROUND:

Although most studies have suggested an increased risk of valvulopathy (primarily regurgitation) with pergolide mesylate use, one study suggested that this problem may also occur with use of the non-ergot-derived dopamine agonists pramipexole dihydrochloride and ropinirole hydrochloride.

OBJECTIVE:

To determine if cardiac valve regurgitation occurs more commonly in patients with Parkinson disease (PD) treated with pergolide than in those treated with nonergot agonists at a comparable dose.

DESIGN:

A case-control study of echocardiographic findings of valve function in patients receiving dopamine agonists for PD.

SETTING:

University-based referral center. Patients Thirty-six patients with idiopathic PD taking pergolide were compared with a matched control group of patients taking nonergot agonists with regard to the frequency and severity of cardiac valve regurgitation. Main Outcome Measure Valve scores (1 indicates trace; 2, mild; 3, moderate; and 4, severe) for the pergolide group were compared with those for the nonergot agonist control group.

RESULTS:

The mean +/- SD valve regurgitation scores in the matched pergolide group compared with the nonergot group were as follows: aortic, 0.83 +/- 1.23 vs 0.19 +/- 0.53 (P = .01); mitral, 1.42 +/- 1.0 vs 0.39 +/- 0.65 (P<.001); and tricuspid, 1.43 +/- 1.0 vs 0.19 +/- 0.53 (P<.001). Lifetime exposure to a dopamine agonist was not statistically different between the pergolide and nonergot agonist groups (P = .18).

CONCLUSIONS:

These data strengthen the conclusion that pergolide contributes to cardiac valve regurgitation when used in the long term as a treatment for PD. There appears to be low risk of cardiac valve regurgitation when using non-ergot-derived dopamine agonists.

PMID:
17353380
DOI:
10.1001/archneur.64.3.377
[Indexed for MEDLINE]
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