Evaluating the Frequency and lntensity of Valvular Heart Disease in Patients with Parkinson's Disease with or without Pergolid Therapy: A Single Blind, Cross-Sectional Study

Abstract

Scientific Background: Pergolide is an ergot-derived dopamine receptor agonist used to treat Parkinson's disease. Very recently, few studies have been published describing the occurrence of multivalvular insufficiency in patients treated with pergolide, suggesting a drug-induced valvulopathy. Objectives: We aimed to assess any relationship between usage of pergolide in Parkinson's disease and valvular involvement.
Matials and Methods: Total of 62 patients with Parkinson's disease (35 treated with pergolide and 27 treated with levodopa) was evaluated by echocardiography. The mean age was 60.57± 10.25 (37-82) years, and the mean duration of Parkinson's disease was 6.73±3.36 (1-14) years in the pergolide group. The mean daily dose of pergolide was 3.12±0.66 (1.50-4.50) mg. Mean duration of pergolide treatment was 34.29±20.10 (7-96) months. The mean age was 71.77±7.29 (60-85) years, and the mean duration of Parkinson's disease was 4.76±3.04 (1-12) years in the levodopa group. The echocardiography was performed by a experienced cardiologist who was blinded to the treatment. We used a valvular scoring system for assessment of valvular involvement: 0=no valvular regurgitation, 1 =mild, 2=moderate and, 3=severe regurgitation. Valvular thickening was looked for its presence. For the mitral valve, regurjitan jet area was measured by planimetry. Systolic pulmonary artery pressures were measured from the tricuspid regurgitant jet.
Results: Valvular heart disease of any type was present in 10 (%28) patients in the pergolide group and 7 (%25) in controls (p=0.81). But severe valvular regurgitation was present in 2 patients (severe tricuspid regurgitant) in the pergolide group whereas no patients in control groups. Valve thickening was documented in 2 patients in the pergolide group and 1 in controls (p=0.71). There was no significant difference between two groups regarding mean pulmonary artery pressures and mitral jet areas.
Conclusions: Our study showed that pergolide may cause valvuler heart disease. However we found that this risk may not be as high as the previous studies showed. But it is also important for all the physicians to keep in mind that there may be possible cardiac side effect given the result of previous reports in the literature.