Pergolide use in Parkinson disease is associated with cardiac valve regurgitation

Neurology. 2004 Jul 27;63(2):301-4. doi: 10.1212/01.wnl.0000129842.49926.07.

Abstract

Objective: To determine if pergolide injures heart valves, by comparing echocardiographic findings in pergolide-treated patients with those of a historical control group.

Methods: Letters were sent to all patients in the authors' practice believed to be taking pergolide, and those responders who wished to continue it were urged to undergo echocardiography. Echocardiograms were obtained on 46 patients, and scores for valvular regurgitation were compared with those from an age-matched control group derived from the Framingham Study. The composite valve regurgitation score was modeled as a linear function of total milligrams lifetime use of pergolide, controlling for age.

Results: Eighty-nine percent of pergolide-treated patients had some degree of valvular insufficiency. For each of the three valves for which there are control data, we found an approximately 2- to 3-fold increased risk of abnormal valves in the pergolide patients (odds ratio [OR] approximately 3) and an estimated 14-fold increased risk of concerning tricuspid regurgitation (OR = 18.4). The composite valve score (the sum of valve scores for each of the four valves) was a function of lifetime pergolide use.

Conclusion: Pergolide may injure cardiac valves, resulting most commonly in tricuspid regurgitation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antiparkinson Agents / adverse effects*
  • Antiparkinson Agents / therapeutic use
  • Aortic Valve Insufficiency / chemically induced
  • Aortic Valve Insufficiency / diagnostic imaging
  • Cardiomyopathy, Restrictive / chemically induced
  • Cohort Studies
  • Disease Progression
  • Female
  • Heart Valve Diseases / chemically induced*
  • Heart Valve Diseases / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve Insufficiency / chemically induced
  • Mitral Valve Insufficiency / diagnostic imaging
  • Parkinson Disease / drug therapy*
  • Pergolide / adverse effects*
  • Pergolide / therapeutic use
  • Pericarditis / chemically induced
  • Pulmonary Valve Insufficiency / chemically induced
  • Pulmonary Valve Insufficiency / diagnostic imaging
  • Single-Blind Method
  • Tricuspid Valve Insufficiency / chemically induced
  • Tricuspid Valve Insufficiency / diagnostic imaging
  • Ultrasonography

Substances

  • Antiparkinson Agents
  • Pergolide