Treatment of Parkinson's disease with pergolide and relation to restrictive valvular heart disease.

Guy Van Camp, Anja Flamez, Bernard Cosyns, Caroline Weytjens, L. Muyldermans, M. Van Zandijcke, Johan De Sutter, P. Santens, P. Decoodt, C. Moerman, Danny Schoors

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329 Citations (Scopus)

Abstract

Abstract: Background Restrictive valvular heart disease has been reported in patients with Parkinson's disease treated with pergolide. However, few data are available on frequency, severity, dose dependency, and reversibility of pergolide-induced disease, nor on the pulmonary pressures of these patients. We aimed to clarify these characteristics in a large group of patients.
Methods 78 patients with Parkinson's disease treated with pergolide and 18 never treated with an ergot-derived dopamine agonist (controls) were evaluated by echocardiography. A valvular scoring system was used, ranging from I (proven ergot-like restrictive valvular heart disease) to 4 (no disease). For the mitral valve, tenting areas and tenting distances were measured. Systolic pulmonary artery pressures were derived from the tricuspid regurgitant jet.

Findings Restrictive valvular heart disease of any type was present in 26 (33%) patients in the pergolide group and none in controls (p=0.0025). Important disease (score 1 or 2) was present in 15 (19%) patients in the pergolide group and none in controls (p=0.066). Mean tenting distances and tenting areas of the mitral valve were 1.08 cm (range 0.55-2.66) and 2.39 cm(2) (0.88-4.59) in the restrictive mitral valve group versus 0.63 cm (0.22-1.20) and 1.39 cm(2) (0.39-3.23) in the non-restrictive group (p=0.003 and p
Interpretation Restrictive valvular heart disease is not a rare finding in patients treated with pergolide. Clinicians should consider changing to a non-ergot drug if this disease is diagnosed.
Original languageEnglish
Pages (from-to)1179-1183
Number of pages5
JournalLancet
Volume363
Issue number9416
Publication statusPublished - 10 Apr 2004

Keywords

  • PRIMARY PULMONARY-HYPERTENSION
  • RETROPERITONEAL FIBROSIS
  • 5-HT2B RECEPTORS
  • FENFLURAMINE
  • DETERMINANTS
  • VALVULOPATHY

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