Department of Internal Medicine, Federal University of Parana, Avenida Agostinho Leao Junior, 285, Curitiba, PR, 80030-110, Brazil.
Pituitary. 2012 Mar;15(1):44-9. doi: 10.1007/s11102-011-0339-7.
Therapy with dopamine agonists has been associated with valvular heart disease (VHD) in Parkinson's disease, raising concern about the safety of these drugs. In hyperprolactinemic patients, the studies have mainly focused on the cardiac effects of cabergoline (CBG), with little information on bromocriptine (BRC). The aim of the present study was to evaluate the prevalence of VHD in patients with prolactinomas treated with CBG and BRC. The CBG group consisted of 51 patients (37 female; age 42.3 ± 13.5 years) who had been taking CBG for at least 1 year (mean 37.8 ± 21.3 months; cumulative doses 16-1,286.8 mg). The BRC group consisted of 19 patients (14 female; age 41.8 ± 11.5 years) who were on BRC for at least 1 year (mean 54.8 ± 30.2 months; cumulative doses 4,687.5-23,478.8 mg). The controls (CTR) were 59 healthy subjects matched for age, sex, and prevalence of arterial hypertension. Participants were subjected to transthoracic echocardiography and the valvular regurgitation was graduated as absent (grade 0), trace (1), mild (2), moderate (3) or severe (4). Compared to CTR, trace mitral (Mi) regurgitation (49% vs. 27.1%; P = 0.02), trace tricuspid (Tri) regurgitation (45.1% vs. 20.3%; P = 0.0003) and mild Tri regurgitation (7.8% vs. 0%; P = 0.0003) were more prevalent with CBG, while trace Tri regurgitation (73.7% vs. 20.3%; P = 0.0004) were more prevalent with BRC. Mitral tenting area was significantly higher in CBG than in BRC and CTR. None of the valvar abnormalities was associated with symptoms. In conclusion, patients with prolactinomas treated with either CBG or BRC showed higher prevalence of trace and mild Tri or Mi regurgitation, but these findings were not clinically significant.
多巴胺激动剂治疗与帕金森病患者的瓣膜性心脏病（VHD）有关，这引起了对这些药物安全性的关注。在高催乳素血症患者中，研究主要集中在卡麦角林（CBG）的心脏效应上，而对溴隐亭（BRC）的信息较少。本研究旨在评估接受 CBG 和 BRC 治疗的泌乳素瘤患者中 VHD 的患病率。CBG 组包括 51 例患者（37 例女性；年龄 42.3 ± 13.5 岁），他们至少服用 CBG 1 年（平均 37.8 ± 21.3 个月；累积剂量 16-1286.8 mg）。BRC 组包括 19 例患者（14 例女性；年龄 41.8 ± 11.5 岁），他们至少服用 BRC 1 年（平均 54.8 ± 30.2 个月；累积剂量 4687.5-23478.8 mg）。对照组（CTR）为 59 名年龄、性别和动脉高血压患病率匹配的健康受试者。参与者接受了经胸超声心动图检查，瓣膜反流程度分为无（0 级）、微量（1 级）、轻度（2 级）、中度（3 级）或重度（4 级）。与 CTR 相比，CBG 患者微量二尖瓣（Mi）反流（49% vs. 27.1%；P = 0.02）、微量三尖瓣（Tri）反流（45.1% vs. 20.3%；P = 0.0003）和轻度 Tri 反流（7.8% vs. 0%；P = 0.0003）更为常见，而 BRC 患者微量三尖瓣反流（73.7% vs. 20.3%；P = 0.0004）更为常见。CBG 的二尖瓣帆面积明显高于 BRC 和 CTR。没有瓣膜异常与症状相关。总之，接受 CBG 或 BRC 治疗的泌乳素瘤患者出现微量和轻度 Tri 或 Mi 反流的患病率较高，但这些发现无临床意义。
