Cabergoline and the risk of valvular lesions in endocrine disease

• Published in: European journal of endocrinology Vol. 159; no. 1; pp. 1 - 5
• Main Authors: Lancellotti, Patrizio, Livadariu, Elena, Markov, Muriel, Daly, Adrian F, Burlacu, Maria-Cristina, Betea, Daniela, Pierard, Luc, Beckers, Albert
• Format: Journal Article
• Language: English
• Published: Colchester BioScientifica 01.07.2008; Portland Press; BioScientifica Ltd
• Subjects: Adult; Aged; Biological and medical sciences; Cardiology. Vascular system; Clinical studies; Cross-Sectional Studies; Dopamine Agonists - adverse effects; Dopamine Agonists - therapeutic use; Dopamine Agonists/adverse effects/therapeutic use; Echocardiography; Endocardial and cardiac valvular diseases; Endocrine System Diseases - drug therapy; Endocrinologie, métabolisme & nutrition; Endocrinology, metabolism & nutrition; Endocrinopathies; Ergolines - adverse effects; Ergolines - therapeutic use; Ergolines/adverse effects/therapeutic use; Female; Fundamental and applied biological sciences. Psychology; Heart; Heart Valve Diseases - chemically induced; Heart Valve Diseases - pathology; Heart Valve Diseases/chemically induced/pathology; Human health sciences; Humans; Male; Medical sciences; Middle Aged; Mitral Valve - drug effects; Mitral Valve - pathology; Mitral Valve Insufficiency - chemically induced; Mitral Valve Insufficiency - pathology; Mitral Valve Insufficiency/chemically induced/pathology; Mitral Valve/drug effects/pathology; Risk Factors; Sciences de la santé humaine; Vertebrates: endocrinology; Endocrinopathy; Agonist; Cardiovascular disease; Risk; Ergot derivatives; Antiparkinson agent; D2 Dopamine receptor; Cardiac valvular disease; Dopamine agonist; Risk factor; Lesion; Cabergoline; Endocrinology
• ISSN: 0804-4643; 1479-683X; 1479-683X
• DOI: 10.1530/EJE-08-0213

AimsThe cardiac valvular risk associated with lower exposure to cabergoline in common endocrine conditions such as hyperprolactinemia is unknown.Methods and resultsWe performed a cross-sectional, case–control echocardiographic study to assess the valvular status in 102 subjects receiving cabergoline for endocrine disorders and 51 matched control subjects. Cabergoline treatment ranged from 12 to 228 months, with a cumulative dose of 18–1718 mg. Valvular regurgitation was equally prevalent in both groups and was almost exclusively mild. Two cabergoline-treated subjects had moderate mitral regurgitation; there was no relationship between cabergoline dose and the presence or severity of mitral valve regurgitation (P=NS). Mitral valve tenting area was significantly greater in the cabergoline group when compared with the control subjects (P=0.03). Mitral valve leaflet thickening was observed in 5.9% of cabergoline-treated subjects; no relationship with the cumulative cabergoline dose was found. No patient had aortic or tricuspid valvular restriction.ConclusionNo significantly increased risk of clinically relevant cardiac valve disorders was found in subjects treated with long-term cabergoline therapy at the doses used in endocrine practice. While exposure to cabergoline appears to be safe during low-dose long-term therapy, an association with subclinical changes in mitral valve geometry cannot be completely excluded.