Abstract 2255: Adverse Effects of Low-Dose Pergolide on Cardiac Function in Patients with Parkinson’s Disease
Pergolide, the ergot-derived dopamine agonist, used in the treatment of Parkinson’s disease (PD), has been associated with an increased risk of valvular heart disease. The purpose of this study was to clarify the adverse effects of low-dose pergolide on cardiac function in patients with PD. We performed echocardiography in 46 patients taking low-dose pergolide (cumulative dose<4000(g)) for PD and 41 age-matched control subjects without PD. We quantified regurgitant lesions by integration of all semiquantitative and quantitative measurements, and a final score was given from grade 1 (mild) to 4 (severe). Composite regurgitation score was calculated by adding the score of aortic, mitral and tricuspid regurgitation. Endomyocardial radial strain, systolic strain rate, and early diastolic strain rate (SRdia) were calculated at the posterior and septal segments of the left ventricular (LV) short axis image. Mitral-valve tenting area was also measured. Blood samples were drawn simultaneously for determination of brain natriuretic peptide (BNP). Composite regurgitation score in patients with PD was significantly higher than that in controls (3.07±2.08 versus 0.91±1.18, p<0.01). There were no significant differences in LV dimensions and ejection fraction, however, endomyocardial peak strain (ϵ) and the absolute value of peak SRdia at the posterior segment were significantly smaller in PD patients than in control subjects (ϵ: 0.42±0.16 versus 0.88±0.27, p<0.01; SRdia: 3.80±1.11 versus 6.86±2.99 (s−1), p<0.05, respectively). In 36 PD patients without clinically important regurgitation (grade 3 to 4) in any valve, a significant correlation was noted between cumulative doses of pergolide and tenting area of the mitral valves (r=0.58, p<0.05). In addition, log BNP positively correlated with mitral tenting area in those patients (r=0.54, p<0.005). These results suggest that even low-dose pergolide would have adverse effects on cardiac function as well as valvular regurgitation in PD patients taking that drug.