No evidence of a detrimental effect of cabergoline therapy on cardiac valves in patients with acromegaly

J Clin Endocrinol Metab. 2012 Sep;97(9):E1714-9. doi: 10.1210/jc.2012-1833. Epub 2012 Jun 21.

Abstract

Context: The effects of cabergoline on cardiac valves have been extensively studied in Parkinson's disease and hyperprolactinemia but not in acromegaly, a condition at risk of cardiac valve abnormalities.

Objective: We examined the prevalence and incidence of heart valve disease and regurgitation in a series of patients with acromegaly treated with cabergoline, by comparison with matched patients who had never received this drug.

Design and setting: We conducted a cross-sectional and longitudinal study in a single referral center.

Patients and methods: Forty-two patients who had received cabergoline at a median cumulative dose of 203 mg for a median of 35 months were compared to 46 patients with acromegaly who had never received cabergoline and who were matched for age, sex, and disease duration. A subgroup of patients receiving cabergoline (n = 26) was evaluated longitudinally before and during cabergoline treatment and compared to a group not receiving cabergoline and followed during the same period (n = 26). Two-dimensional and Doppler echocardiographic findings were reviewed by two cardiologists blinded to treatment.

Results: Demographic and clinical features were not significantly different between the groups. Compared to acromegalic controls, patients receiving cabergoline did not have a higher prevalence or incidence of valve abnormalities. A slightly higher prevalence of aortic valve regurgitation and remodeling was found in the controls relative to the cabergoline-treated patients (P < 0.02 and P < 0.03, respectively), but this was related to the presence of aortic dilatation.

Conclusion: Cabergoline therapy is not associated with an increased risk of cardiac valve regurgitation or remodeling in acromegalic patients at the doses used in this study.

MeSH terms

  • Acromegaly / complications*
  • Acromegaly / diagnostic imaging
  • Adolescent
  • Adult
  • Aged
  • Aortic Valve Insufficiency / chemically induced
  • Aortic Valve Insufficiency / epidemiology
  • Cabergoline
  • Cross-Sectional Studies
  • Dopamine Agonists / adverse effects*
  • Echocardiography
  • Echocardiography, Doppler
  • Ergolines / adverse effects*
  • Female
  • Heart Valve Diseases / chemically induced*
  • Heart Valve Diseases / diagnostic imaging*
  • Heart Valve Diseases / etiology
  • Heart Valves / diagnostic imaging*
  • Humans
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Mitral Valve Insufficiency / chemically induced
  • Mitral Valve Insufficiency / epidemiology
  • Retrospective Studies
  • Tricuspid Valve Insufficiency / chemically induced
  • Tricuspid Valve Insufficiency / epidemiology
  • Young Adult

Substances

  • Dopamine Agonists
  • Ergolines
  • Cabergoline