Meta-analysis of heart valve abnormalities in Parkinson's disease patients treated with dopamine agonists

Valvular heart disease in patients being treated with ergot-derivative dopamine agonists (Ergot-DA) for Parkinson's disease has been reported to occur as a consequence of serotonine receptor stimulation. Goal of this analysis was to estimate the incidence of those changes from recently published studies and to determine its clinical relevance. Medline searches were performed to identify cross-sectional, echocardiographic studies comparing patients treated with dopamine agonists or controls, in terms of valvular changes. Observational studies of valve changes in Parkinsonian patients were used to estimate the incidence of severe valvulopathy. The results from 7 cross-sectional studies including 477 patients treated with Ergot-DA, 127 patients with non-Ergot-DA, and 364 control patients were analyzed. Moderate-to-severe valvular changes were detected in 26% of patients treated with Ergot-DA, 10% of patients treated with non-Ergot DA, and 10% of control patients. Severe valvulopathy was less than 1% both in cross-sectional and observational studies. The high rate of moderate valvular changes in patients treated with Ergot-DA suggests that close surveillance of the patients is required. Severe valvulopathy was less than 1% in the studies analyzed.