Severe multivalvular heart disease: a new complication of the ergot derivative dopamine agonists

Article Article scientifique Rapport de cas Severe multivalvular heart disease: a new complication of the ergot derivative dopamine agonists eng 2004 author Horvath Judit 673705 author Fross Robin D author Kleiner-Fisman Galit author Lerch René 22017 author Stalder Hans 25291 author Liaudat Suzanne 549949 author Raskoff William J author Flachsbart Keith D author Rakowski Harry author Pache Jean-Claude 513830 author Burkhard Pierre 0000-0002-7459-5778 92389 author Lang Anthony 656-662 10.1002/mds.20201 15197703 0885-3185 We report on 4 new cases of valvular heart disease in Parkinson's disease patients treated with the ergot derivative dopamine agonists pergolide and cabergoline. Noninflammatory fibrotic degeneration of cardiac valves has been reported to occur in patients with carcinoid syndrome and to occasionally complicate therapies with the anti-migraine ergot alkaloid ergotamine and methysergide and with the appetite suppressants fenfluramine and dexfenfluramine. In these cases, the pathogenesis is suspected to involve serotonin-mediated abnormal fibrogenesis by means of the 5-HT2B receptors, which are expressed in the fibroblasts of heart valves. Based on strikingly similar echocardiographic and histopathological features, we strongly suspect that ergot-derived dopamine agonists may cause a valvular heart disease nearly identical to that seen in those conditions. These cases add to a rapidly growing and worrying list of similar published reports, suggesting that we may well be facing a novel, yet unrecognized, complication of this class of agents, which are widely used not only in Parkinson's disease but also in restless legs syndrome and various common endocrine dysfunctions. Therefore, until more is known about the true prevalence of this side effect, we propose that an assessment of cardiac function be performed before and in the course of a long-term therapy with ergot derivative dopamine agonists. Adult Aged Carbidopa/adverse effects/therapeutic use Dopamine Agonists/adverse effects/therapeutic use Drug Combinations Echocardiography, Transesophageal/instrumentation Ergolines/adverse effects/chemistry/therapeutic use Ergot Alkaloids/analysis Female Heart Valve Diseases/chemically induced/pathology/ultrasonography Humans Levodopa/adverse effects/therapeutic use Male Parkinson Disease/drug therapy Pergolide/adverse effects/chemistry/therapeutic use Dewey 576 Dewey 616 Dewey 616.07 136 Département de biologie structurale et bioinformatique 21E 137 Département de pathologie et immunologie 21F 56 Département de médecine 221 false 392 Groupe Pache Jean-Claude (pathologie clinique) 658 Movement disorders 19 6 cb1a53a7-f718-4801-849a-4ddc1cfd0385 Article (Published version) Restricted 20201_ftp.pdf 308573 application/pdf restrictedAccess Faculté de médecine / Section de médecine fondamentale / Département de biologie structurale et bioinformatique Faculté de médecine / Section de médecine fondamentale / Département de pathologie et immunologie Faculté de médecine / Section de médecine clinique / Département de médecine

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Severe multivalvular heart disease: a new complication of the ergot derivative dopamine agonists	Movement disorders			2004	580	0

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Liaudat, Suzanne