Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Clin Endocrinol (Oxf). 2010 Jan;72(1):53-8. doi: 10.1111/j.1365-2265.2009.03608.x. Epub 2009 Apr 17.
Ergot-derived dopamine agonists are associated with increased risk of valvular dysfunction in Parkinson's disease. The risk of valvular disease associated with lower doses of cabergoline used to treat prolactinomas remains controversial.
To determine whether there is an association of cabergoline and valvular function in patients with hyperprolactinaemia according to gender.
Case-record retrospective study.
Outpatient neuroendocrine clinical centre at a tertiary care hospital.
One hundred patients (48 men and 52 women) with hyperprolactinaemia who had an echocardiogram while receiving cabergoline for at least 6 months.
One hundred controls (48 men and 52 women) selected from Massachusetts general hospital (MGH) database of echocardiograms without clinically significant findings, matched to patients for age, gender, body mass index (BMI) and hypertension.
Echocardiogram.
There were no significant differences in valvular function in patients compared with controls. However, women patients had a higher prevalence of mild tricuspid regurgitation (TR) than female controls (15.4%vs. 1.9%, P = 0.03). Among men only, patients had more trace TR than controls (68.8%vs. 45.8%, P = 0.02). The mild valvular regurgitation in patients was not clinically significant and did not correlate with dose, duration or cumulative dose.
Overall cabergoline was not associated with valvulopathy. However, subdivided by gender, hyperprolactinaemic men and women had higher prevalence of trace or mild TR, respectively, compared with gender matched controls. There may be gender differences in valvular dysfunction associated with cabergoline. Longer term, larger studies are necessary to evaluate definitively an effect of cabergoline on valvular function in hyperprolactinaemic patients.
麦角衍生的多巴胺激动剂与帕金森病患者的瓣膜功能障碍风险增加有关。用于治疗催乳素瘤的较低剂量卡麦角林与瓣膜疾病风险之间的关系仍存在争议。
根据性别确定卡麦角林与高催乳素血症患者瓣膜功能之间是否存在关联。
病例记录回顾性研究。
一家三级保健医院的门诊神经内分泌临床中心。
100 例（48 名男性和 52 名女性）高催乳素血症患者，他们在接受卡麦角林治疗至少 6 个月后进行了超声心动图检查。
从马萨诸塞州总医院（MGH）超声心动图数据库中选择 100 名对照者（48 名男性和 52 名女性），他们没有临床显著发现，与患者年龄、性别、体重指数（BMI）和高血压相匹配。
超声心动图。
与对照组相比，患者的瓣膜功能无明显差异。然而，女性患者中轻度三尖瓣反流（TR）的发生率高于女性对照组（15.4%vs. 1.9%，P = 0.03）。仅在男性中，患者的微量 TR 比对照组多（68.8%vs. 45.8%，P = 0.02）。患者的轻度瓣膜反流并无临床意义，与剂量、持续时间或累积剂量无关。
总体而言，卡麦角林与瓣膜病无关。然而，按性别细分，高催乳素血症男性和女性分别比性别匹配的对照组更常见微量或轻度 TR。卡麦角林相关瓣膜功能障碍可能存在性别差异。需要进行更长期、更大规模的研究，以明确评估卡麦角林对高催乳素血症患者瓣膜功能的影响。
