No clinically significant valvular regurgitation in long-term cabergoline treatment for prolactinoma

Background An association between treatment for Parkinson's disease with certain dopaminergic drugs and development of cardiac valve impairment has been reported. Recent studies in hyperprolactinaemic patients treated with cabergoline (CAB) have shown either no significant findings or mild tricuspid regurgitation. Objective To determine the prevalence of cardiac valve dysfunction in patients with hyperprolactinaemic conditions chronically treated with CAB or bromocriptine (BR). Design Retrospective, multicentric, cross-sectional study of cases vs controls. Patients Eighty-three hyperprolactinaemic patients (15 men, 68 women aged 16.763 similar to years; 64% microprolactinomas, 28% macroprolactinomas and 8% other etiologies) from three Spanish university hospitals chronically treated with BR (14562.5 similar to weeks, cumulative dose 5603 similar to +/-similar to 7729 similar to mg) or CAB (12765 similar to weeks, 217.4 +/- 306.6 similar to mg). Measurements Transthoracic echocardiographic assessment of valvular regurgitation and thickening, mitral valve tenting area and left-ventricular ejection fraction from 83 patients were compared with results from 58 age- and sex-matched controls and correlated with cumulative doses of dopaminergic drugs. Results No significant differences in valvular regurgitation, valve thickness or any other echocardiographic parameter were observed between controls and patients, except for 15 patients in the higher quartile of CAB cumulative dose (>180 similar to mg), with increased prevalence of mild tricuspid regurgitation (6/15, 40% vs 8/58, 13.8%, P similar to=similar to 0.024; OR 4.1; 1.114.9). High BR cumulative dose was associated with no significant findings. Conclusions No increased valvular involvement was found after long-term dopaminergic therapy for hyperprolactinaemia except for a significant increase in mild tricuspid regurgitation associated with high cumulative doses of CAB; BR seems spared from this adverse effect, although the low number of cases limits this analysis. Cumulative dose registry and long-term studies are warranted to definitely clarify this item.