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Valvular heart disease in Parkinson's disease patients treated with dopamine agonists: a reader-blinded monocenter

Susann Junghanns1, Joerg T Fuhrmann, Gregor Simonis

  • 1Department of Neurology, Technical University of Dresden, Dresden, Germany.

Movement Disorders : Official Journal of the Movement Disorder Society
|November 10, 2006
PubMed

Insights

Ergot dopamine agonists (DAs) are linked to a higher risk of valvular heart disease (VHD) in Parkinson's disease patients compared to non-ergot DAs. Echocardiography effectively detects this VHD.

Area of Science:

  • Cardiology
  • Neurology
  • Pharmacology

Background:

  • Fibrotic valvular heart disease (VHD) has been associated with ergot dopamine agonists (DAs).
  • Existing data is insufficient to establish clinical relevance and compare ergot vs. non-ergot DAs.
  • Parkinson's disease (PD) patients are often treated with dopamine agonists.

Purpose of the Study:

  • To evaluate the effects of ergot and non-ergot DAs on heart valve morphology and function in PD patients.
  • To determine the frequency and clinical relevance of dopamine agonist-induced VHD.
  • To compare VHD prevalence between ergot DA, non-ergot DA, and control groups.

Main Methods:

  • Transthoracic echocardiography was used to evaluate 85 PD patients on DAs and 38 age-matched controls.
  • Valvular pathology was assessed using established criteria for valvular regurgitation and a VHD scoring system.
  • Four DAs were studied: pergolide, cabergoline (ergot), ropinirole, and pramipexole (non-ergot).

Main Results:

  • A significantly higher frequency of VHD was observed in patients treated with ergot DAs compared to non-ergot DA users and controls (22% vs. 3% vs. 0%, P = 0.001).
  • Moderate VHD was found in 22% of ergot DA patients, 3% of non-ergot DA patients, and none of the controls.
  • No correlations were found between echocardiographic findings and treatment duration, cumulative dose, age, or vascular risk factors.

Conclusions:

  • Ergot DAs are associated with a higher prevalence of VHD in Parkinson's disease patients than non-ergot DAs and controls.
  • Standard echocardiography is adequate for detecting VHD in PD patients undergoing DA therapy.
  • Further research may be warranted to elucidate mechanisms and long-term implications.

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