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卡麦角林与内分泌疾病中的瓣膜病变风险

Cabergoline and the risk of valvular lesions in endocrine disease.

作者信息

Lancellotti Patrizio, Livadariu Elena, Markov Muriel, Daly Adrian F, Burlacu Maria-Cristina, Betea Daniela, Pierard Luc, Beckers Albert

机构信息

Department of Cardiology, Centre Hospitalier Universitaire de Liège, Domaine Universitaire du Sart-Tilman, University of Liège, B-4000 Liège, Belgium.

出版信息

Eur J Endocrinol. 2008 Jul;159(1):1-5. doi: 10.1530/EJE-08-0213. Epub 2008 May 2.

Abstract

AIMS

The cardiac valvular risk associated with lower exposure to cabergoline in common endocrine conditions such as hyperprolactinemia is unknown.

METHODS AND RESULTS

We performed a cross-sectional, case-control echocardiographic study to assess the valvular status in 102 subjects receiving cabergoline for endocrine disorders and 51 matched control subjects. Cabergoline treatment ranged from 12 to 228 months, with a cumulative dose of 18-1718 mg. Valvular regurgitation was equally prevalent in both groups and was almost exclusively mild. Two cabergoline-treated subjects had moderate mitral regurgitation; there was no relationship between cabergoline dose and the presence or severity of mitral valve regurgitation (P=NS). Mitral valve tenting area was significantly greater in the cabergoline group when compared with the control subjects (P=0.03). Mitral valve leaflet thickening was observed in 5.9% of cabergoline-treated subjects; no relationship with the cumulative cabergoline dose was found. No patient had aortic or tricuspid valvular restriction.

CONCLUSION

No significantly increased risk of clinically relevant cardiac valve disorders was found in subjects treated with long-term cabergoline therapy at the doses used in endocrine practice. While exposure to cabergoline appears to be safe during low-dose long-term therapy, an association with subclinical changes in mitral valve geometry cannot be completely excluded.

摘要

目的

在常见内分泌疾病如高泌乳素血症中,较低剂量使用卡麦角林与心脏瓣膜风险之间的关系尚不清楚。

方法与结果

我们进行了一项横断面病例对照超声心动图研究,以评估102例接受卡麦角林治疗内分泌疾病的患者和51例匹配对照者的瓣膜状态。卡麦角林治疗时间为12至228个月,累积剂量为18 - 1718毫克。两组中瓣膜反流的发生率相同,且几乎均为轻度。两名接受卡麦角林治疗的患者有中度二尖瓣反流;卡麦角林剂量与二尖瓣反流的存在或严重程度之间无相关性(P = 无显著性差异)。与对照者相比,卡麦角林组的二尖瓣帐篷面积显著更大(P = 0.03)。在5.9%接受卡麦角林治疗的患者中观察到二尖瓣叶增厚;未发现与卡麦角林累积剂量有关。没有患者出现主动脉瓣或三尖瓣受限。

结论

在内分泌实践中使用的剂量下,长期接受卡麦角林治疗的患者未发现临床相关心脏瓣膜疾病风险显著增加。虽然低剂量长期治疗期间使用卡麦角林似乎是安全的,但不能完全排除与二尖瓣几何形状亚临床变化的关联。

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