Kim Ji-Youn, Chung Eun Joo, Park Seung Woo, Lee Won Yong
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Mov Disord. 2006 Aug;21(8):1261-4. doi: 10.1002/mds.20931.
Valvular heart disease, associated with ergot derivative dopamine agonists, has been reported in patients with Parkinson's disease (PD). There are few comparative studies on the frequency, severity, and dose dependency of valvular disease associated with ergot derivatives. We analyzed these factors in 58 PD patients who were taking ergot derivatives (22 were taking bromocriptine and 36 were taking pergolide) and compared them with 20 age-matched controls based on the two-dimensional echocardiographic findings. Aortic, mitral, and tricuspid valvular thicknesses, as well as tenting areas and tenting distance of the mitral valve were measured. We also assessed the correlation between the cumulative or daily doses of ergot derivatives and each valvular parameter. There was no significant increase in the frequency of valvulopathy in the PD patients taking bromocriptine or pergolide. We identified a positive correlation between the daily dose of pergolide and the tenting area of the mitral valve (r = 0.385; P = 0.020). However, other valvular parameters were not found to correlate with the age, disease duration, treatment duration, or dosage of medication. Our study failed to uncover definitive harmful effects of ergot derivative dopamine agonists on cardiac valves; this is considering the relatively lower daily doses than other reported cases. To establish a dosage dependency with valvulopathy, a more detailed study with higher doses of ergot derivatives for longer duration of treatment may be needed.
帕金森病（PD）患者中已报告与麦角衍生物多巴胺激动剂相关的心脏瓣膜病。关于麦角衍生物相关瓣膜病的频率、严重程度和剂量依赖性的比较研究很少。我们分析了58例服用麦角衍生物的PD患者（22例服用溴隐亭，36例服用培高利特）的这些因素，并根据二维超声心动图结果将他们与20名年龄匹配的对照进行比较。测量了主动脉瓣、二尖瓣和三尖瓣的厚度，以及二尖瓣的帐篷面积和帐篷距离。我们还评估了麦角衍生物的累积剂量或每日剂量与每个瓣膜参数之间的相关性。服用溴隐亭或培高利特的PD患者中瓣膜病的频率没有显著增加。我们发现培高利特的每日剂量与二尖瓣的帐篷面积之间存在正相关（r = 0.385；P = 0.020）。然而，未发现其他瓣膜参数与年龄、病程、治疗时间或药物剂量相关。考虑到与其他报告病例相比每日剂量相对较低，我们的研究未能发现麦角衍生物多巴胺激动剂对心脏瓣膜有明确的有害影响。为了确定与瓣膜病的剂量依赖性，可能需要进行一项更详细的研究，使用更高剂量的麦角衍生物并延长治疗时间。
