No Evidence of a Detrimental Effect of Cabergoline Therapy on Cardiac Valves in Patients with Acromegaly

• Published in: The journal of clinical endocrinology and metabolism 2012-09, Vol.97 (9), p.E1714-E1719
• Main Authors: Maione, Luigi, Garcia, Cyril, Bouchachi, Amir, Kallel, Nozha, Maison, Patrick, Salenave, Sylvie, Young, Jacques, Assayag, Patrick, Chanson, Philippe
• Format: Article
• Language: English
• Subjects: Acromegaly - complications; Acromegaly - diagnostic imaging; Adolescent; Adult; Aged; Aortic Valve Insufficiency - chemically induced; Aortic Valve Insufficiency - epidemiology; Cross-Sectional Studies; Dopamine Agonists - adverse effects; Echocardiography; Echocardiography, Doppler; Ergolines - adverse effects; Female; Heart Valve Diseases - chemically induced; Heart Valve Diseases - diagnostic imaging; Heart Valve Diseases - etiology; Heart Valves - diagnostic imaging; Humans; Hypertrophy, Left Ventricular - diagnostic imaging; Longitudinal Studies; Male; Middle Aged; Mitral Valve Insufficiency - chemically induced; Mitral Valve Insufficiency - epidemiology; Retrospective Studies; Tricuspid Valve Insufficiency - chemically induced; Tricuspid Valve Insufficiency - epidemiology; Young Adult
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2012-1833

Context: The effects of cabergoline on cardiac valves have been extensively studied in Parkinson's disease and hyperprolactinemia but not in acromegaly, a condition at risk of cardiac valve abnormalities. Objective: We examined the prevalence and incidence of heart valve disease and regurgitation in a series of patients with acromegaly treated with cabergoline, by comparison with matched patients who had never received this drug. Design and Setting: We conducted a cross-sectional and longitudinal study in a single referral center. Patients and Methods: Forty-two patients who had received cabergoline at a median cumulative dose of 203 mg for a median of 35 months were compared to 46 patients with acromegaly who had never received cabergoline and who were matched for age, sex, and disease duration. A subgroup of patients receiving cabergoline (n = 26) was evaluated longitudinally before and during cabergoline treatment and compared to a group not receiving cabergoline and followed during the same period (n = 26). Two-dimensional and Doppler echocardiographic findings were reviewed by two cardiologists blinded to treatment. Results: Demographic and clinical features were not significantly different between the groups. Compared to acromegalic controls, patients receiving cabergoline did not have a higher prevalence or incidence of valve abnormalities. A slightly higher prevalence of aortic valve regurgitation and remodeling was found in the controls relative to the cabergoline-treated patients (P < 0.02 and P < 0.03, respectively), but this was related to the presence of aortic dilatation. Conclusion: Cabergoline therapy is not associated with an increased risk of cardiac valve regurgitation or remodeling in acromegalic patients at the doses used in this study.