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首页> 外文期刊>Cardiovascular therapeutics >Regression of cardiac valvulopathy related to ergot-derived dopamine agonists.
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Regression of cardiac valvulopathy related to ergot-derived dopamine agonists.

机译：与麦角衍生的多巴胺激动剂有关的心脏瓣膜病的消退。

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AIMS: In a previous echocardiographic prevalence study we reported a significant increase in the frequency of heart valve regurgitation in patients with Parkinson's disease taking the ergot-derived dopamine agonists pergolide and cabergoline versus controls. We followed-up our original cohort of patients to ascertain whether valvulopathy regressed after discontinuation of treatment and/or its incidence increased over time. METHODS: Prospective follow-up of 101 patients treated with ergot-derived dopamine agonists included in the prevalence study: 53 given pergolide and 48 cabergoline (64% male; 66.4 +/- 8.7 years of age, 11.5 +/- 5.9 years of disease, 21.8 +/- 5.9 months of follow-up); 55 stopped treatment while 46 continued. The main outcomes measures, were: echocardiographic quantification of regurgitant valve disease, abnormal leaflet, or cusp thickening and measurement of mitral valve tenting area. RESULTS: Valve abnormalities regressed in about one third of patients with significant multivalvular and in about half of the patients with monovalvular regurgitation who withdrew; no progression was observed in remaining patients. Patients continuing ergot-derived dopamine agonists showed progression of cardiac valvulopathy: seven new cases with three to four regurgitation grade of any valve occurred during follow-up; this regarded also patients who had been on pergolide for many years. CONCLUSION: Owing to the persistence of risk of heart valve damage over time and the lack of its mid-term reversibility in many patients, we believe that pergolide and cabergoline should be prescribed only when therapeutic alternatives with a better risk/benefit ratio are unavailable and the patient has access to echocardiography.
机译：目的：在先前的超声心动图患病率研究中，我们报道了麦角衍生的多巴胺激动剂培高利特和卡麦角林与对照组相比，帕金森氏病患者心脏瓣膜返流的频率显着增加。我们随访了最初的患者队列，以确定中止治疗后瓣膜病是否消退和/或其发生率是否随时间增加。方法：对101名接受麦角多巴胺激动剂治疗的患者进行的随访研究包括在患病率研究中：53例培高利特和48例卡麦角林（男性为64％; 66.4 +/- 8.7岁，疾病为11.5 +/- 5.9岁，随访21.8 +/- 5.9个月）; 55例停止治疗，而46例继续治疗。主要的预后指标包括：超声心动图定量的反流性瓣膜疾病，异常的小叶或尖瓣增厚，以及二尖瓣膜展张面积的测量。结果：大约三分之一的具有明显多瓣膜关闭的患者和大约一半的单瓣关闭不全的患者退出时瓣膜异常消退。在其余患者中未观察到进展。持续由麦角衍生的多巴胺激动剂的患者表现出心脏瓣膜病的进展：7例在随访期间发生3到4个瓣膜反流等级的新病例;这也考虑了多年服用培高利特的患者。结论：由于许多患者长期存在心脏瓣膜损伤的风险，并且缺乏中期可逆性，因此我们认为，只有在没有风险/获益率更高的替代疗法且没有可替代药物和可卡麦角林的情况下，才应处方培高利特和卡麦角林患者可以进行超声心动图检查。

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