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Low dose cabergoline for hyperprolactinaemia is not associated with clinically significant valvular heart disease

A Wakil, University of Hull, Hull, HU3 2RW, United Kingdom
A Rigby, Department of Academic Cardiology, University of Hull, Hull, United Kingdom
A Clark, Department of Academic Cardiology, Castle Hill Hospital, Cottingham, United Kingdom
S Atkin, Department of Endocrinology, Diabetes & Metabolism, Hull York Medical School, Hull, United Kingdom

Correspondence: Ammar Wakil, Email: ammar.wakil{at}gmail.com

Abstract

Objective: Recent trials suggest that using ergot-derived dopamine agonists such as cabergoline in the treatment of Parkinsons disease is associated with an increased risk of valvular heart disease. However, the dose of cabergoline used to treat hyperprolactinaemia is considerably less than that used in Parkinsons disease.

Design and Methods: A cross-sectional comparative assessment. Forty four patients treated with cabergoline for hyperprolactinaemia underwent transthoracic echocardiography and were compared to 566 sequential subjects complaining of palpitations, taken from a contemporary echocardiography database.

Results: The mean cumulative dose of cabergoline in the cases was 311 mg. There was no significant, severe or moderate, right or left sided valvular regurgitation in either group. Left heart: In the mitral and aortic valves, the rate of mild and trivial valvular regurgitation was not different between the two groups. Right heart: Mild tricuspid and pulmonary regurgitation on colour Doppler alone was increased significantly in the cabergoline group, odds ratios of 3.1 and 7.8 respectively (95% C.I. 1.0-9.6 and 0.8-78.4, P = 0.04 and <0.0001 respectively).

Conclusion: Cabergoline at doses sufficient to suppress hyperprolactinaemia for a period of 3-4 years is not associated with an increased risk of clinically significant valvular regurgitation.