Leibowitz M, Lieberman A N, Neophytides A, Gopinathan G, Goldstein M
Adv Neurol. 1983;37:121-30.
The effect of pergolide, a semisynthetic ergot alkaloid, on the cardiovascular system of 40 patients with Parkinson's disease (PD) was evaluated. The mean daily dose of pergolide was 2.4 mg (range, 0.1 to 10 mg). The mean duration of follow-up was 6 months (range, 2 weeks to 20 months). The 40 patients were selected only on the basis of severe PD. All 13 patients in the first part of the study underwent 1 to 5 days of Holter monitoring before starting pergolide. Monitoring was then carried out for an additional period of between 2 and 10 weeks while the patients were on pergolide. Seven of the 13 patients manifested repetitive ventricular rhythms. These were isolated and unassociated with increases in premature ventricular contractions. The dose at which the RVRs occurred was a function of the presence or absence of heart disease. The changes occurred below 3 mg/day in patients with heart disease and above 3 mg/day in patients without heart disease. Pergolide was discontinued in three of the patients with heart disease. It was concluded that pergolide may, in the diseased heart, predispose to RVRs. In the second part of the study, Holter monitoring was carried out only at the discretion of the cardiologist, and five patients were so monitored. None of these patients was rejected from the study. Only one patient (with heart disease) of the 27 patients in the second part of the study experienced an arrhythmia. This consisted of an increase in PVCs on 4 mg/day of pergolide. Pergolide was discontinued. Eight of the 40 patients in these early dose-ranging studies experienced orthostasis, two with syncope, immediately on addition of pergolide (0.1 to 0.4 mg) to levodopa. The orthostasis could be eliminated in all but two patients by reducing or discontinuing levodopa.
评估了半合成麦角生物碱培高利特对40例帕金森病（PD）患者心血管系统的影响。培高利特的平均日剂量为2.4毫克（范围为0.1至10毫克）。平均随访时间为6个月（范围为2周至20个月）。40例患者仅根据严重的帕金森病进行选择。研究第一部分的所有13例患者在开始服用培高利特之前接受了1至5天的动态心电图监测。然后在患者服用培高利特期间再进行2至10周的监测。13例患者中有7例出现重复性室性心律。这些是孤立的，与室性早搏增加无关。出现重复性室性心律的剂量是心脏病存在与否的函数。在有心脏病的患者中，变化发生在每日3毫克以下，而在无心脏病的患者中，变化发生在每日3毫克以上。3例有心脏病的患者停用了培高利特。得出的结论是，在患病心脏中，培高利特可能易引发重复性室性心律。在研究的第二部分，仅由心脏病专家酌情进行动态心电图监测，5例患者接受了这样的监测。这些患者均未被排除在研究之外。研究第二部分的27例患者中只有1例（有心脏病）出现心律失常。这包括在服用4毫克/天培高利特时室性早搏增加。培高利特被停用。在这些早期剂量范围研究的40例患者中，有8例在将培高利特（0.1至0.4毫克）添加到左旋多巴后立即出现体位性低血压，其中2例伴有晕厥。除2例患者外，通过减少或停用左旋多巴，体位性低血压均可消除。
