Khare Shruti, Lila Anurag R, Patil Rishikesh, Phadke Milind, Kerkar Prafulla, Bandgar Tushar, Shah Nalini S
Department of Endocrinology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India.
Department of Cardiology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India.
Indian J Endocrinol Metab. 2017 Jan-Feb;21(1):154-159. doi: 10.4103/2230-8210.196010.
Clinical relevance of association of cabergoline use for hyperprolactinemia and cardiac valvulopathy remains unclear.
The aim of the study was to determine the prevalence of valvular heart abnormalities in patients taking cabergoline for the treatment of prolactinoma and to explore any associations with the cumulative dose of drug used.
A cross-sectional echocardiographic study was performed in patients who were receiving cabergoline therapy for prolactinoma.
Hundred (61 females, 39 males) prolactinoma cases (81 macroprolactinoma and 19 microprolactinoma) were included in the study. The mean age at presentation was 33.9 ± 9.0 years (range: 16-58 years). The mean duration of treatment was 53.11 ± 43.15 months (range: 12-155 months). The mean cumulative dose was 308.6 ± 290.2 mg (range: 26-1196 mg; interquartile range: 104-416 mg). Mild mitral regurgitation was present in one patient (cumulative cabergoline dose 104 mg). Mild tricuspid regurgitation was present in another two patients (cumulative cabergoline dose 52 mg and 104 mg). Aortic and pulmonary valve functioning was normal in all the cases. There were no cases of significant valvular regurgitation (moderate to severe, Grade 3-4). None of the patients had morphological abnormalities such as thickening, calcification, and restricted mobility of any of the cardiac valves.
Cabergoline appears to be safe in patients with prolactinoma up to the cumulative dose of ~300 mg. The screening for valvulopathy should be restricted to those with higher cumulative cabergoline exposure.
使用卡麦角林治疗高泌乳素血症与心脏瓣膜病之间关联的临床相关性仍不明确。
本研究旨在确定服用卡麦角林治疗泌乳素瘤患者的心脏瓣膜异常患病率，并探讨其与所用药物累积剂量的任何关联。
对接受卡麦角林治疗泌乳素瘤的患者进行了一项横断面超声心动图研究。
本研究纳入了100例泌乳素瘤病例（61例女性，39例男性）（81例大泌乳素瘤和19例微泌乳素瘤）。就诊时的平均年龄为33.9±9.0岁（范围：16 - 58岁）。平均治疗持续时间为53.11±43.15个月（范围：12 - 155个月）。平均累积剂量为308.6±290.2毫克（范围：26 - 1196毫克；四分位间距：104 - 416毫克）。1例患者出现轻度二尖瓣反流（卡麦角林累积剂量104毫克）。另外2例患者出现轻度三尖瓣反流（卡麦角林累积剂量52毫克和104毫克）。所有病例的主动脉瓣和肺动脉瓣功能均正常。无显著瓣膜反流病例（中度至重度，3 - 4级）。所有患者均无心脏瓣膜增厚、钙化及活动受限等形态学异常。
对于泌乳素瘤患者，卡麦角林累积剂量达约300毫克时似乎是安全的。心脏瓣膜病筛查应仅限于卡麦角林累积暴露量较高的患者。
