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Cabergoline and the risk of valvular lesions in endocrine disease

P Lancellotti, Department of Cardiology, CHU de Liege, Liege, Belgium
E Livadariu, Service d'Endocrinologie, CHU de Liege, Liege, Belgium
M Markov, Department of Cardiology, CHU de Liege, Liege, Belgium
A Daly, Service d'Endocrinologie, CHU de Liege, Liege, Belgium
M Burlacu, Service d'Endocrinologie, CHU de Liege, Liege, Belgium
D Betea, Service d'Endocrinologie, CHU de Liege, Liege, Belgium
L Pierard, Department of Cardiology, CHU de Liege, Liege, Belgium
A Beckers, Service d'Endocrinologie, CHU de Liege, Liege, Belgium

Correspondence: Albert Beckers, Email: albert.beckers{at}chu.ulg.ac.be

Abstract

Aims: The cardiac valvular risk associated with lower exposure to cabergoline in common endocrine conditions such as hyperprolactinemia is unknown.

Methods and Results: We performed a cross-sectional, case-control echocardiographic study to assess valvular status in 102 subjects receiving cabergoline for endocrine disorders and 51 matched control subjects. Cabergoline treatment ranged from 12-228 months, with a cumulative dose of 18-1718 mg. Valvular regurgitation was equally prevalent in both groups and was almost exclusively mild. Two cabergoline-treated subjects patients had moderate mitral regurgitation; there was no relationship between cabergoline dose and the presence or severity of mitral valve regurgitation P=NS). Mitral valve tenting area was significantly greater in the cabergoline group as compared to the control subjects (P=0.03). Mitral valve leaflet thickening was observed in 5.9% of cabergoline-treated subjects; no relationship with the cumulative cabergoline dose was found. No patient had aortic or tricuspid valvular restriction.

Conclusion: No significantly increased risk of clinically-relevant cardiac valve disorders were found in subjects treated with long-term cabergoline therapy at the doses used in endocrine practice. While exposure to cabergoline appears to be safe during low-dose long term therapy, an association with subclinical changes in mitral valve geometry cannot be completely excluded.

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