MADRID — Patients with a cardiovascular abnormality who also take an ergotamine-derived dopamine agonist are at an increased risk for a worsening of their heart problems.
But “most patients who stop ergotamine-derived treatment seem to remain stable or improve their cardiovascular abnormality over 1 year,” Dr. Videke G. Rasmussen wrote in a poster presented at the annual congress of the European Federation of Neurological Societies.
Dr. Rasmussen's prospective observational study included 144 patients with Parkinson's disease, of whom 40 had a diagnosis of cardiac valve disease or pulmonary hypertension confirmed by echo-cardiogram at the beginning of the study.
Aortic regurgitation was present in 32 patients (mild, 16; moderate, 14; severe, 2). One patient had moderate mitral regurgitation. Two had moderate tricuspid regurgitation; one of these also had moderate mitral regurgitation, and the other also had mild aortic regurgitation. Two patients had mitral and tricuspid regurgitation plus pulmonary hypertension, and two had isolated pulmonary hypertension.
At baseline, 35 patients were taking ergo- tamine-derived dopamine agonists (EDDA) and 8 were taking non-ergotamine-derived drugs (non-EDDA). After the initial echo-cardiogram, 5 patients taking EDDAs continued that treatment, and 27 switched to a non-EDDA. The eight who were originally taking a non-EDDA continued to do so.
After a mean of 15 months, patients had repeat echocardiograms that were compared with baseline. Of the five who continued on an EDDA, one showed improvement in the cardiovascular condition, one showed no change, and three showed worsening of their condition. Of the 27 who switched from an EDDA to a non-EDDA, 7 (26%) showed improvement, 15 (56%) had no change, and 5 (18%) showed worsening.
None of the eight who took a non-EDDA for the entire study period showed a worsening in their cardiac condition during the follow-up visit. One patient showed improvement; seven showed no change.
Dr. Rasmussen, a cardiologist at Aarhus (Denmark) University Hospital, had no conflicts of interest with regard to the study.