Valvular heart disease in patients taking pergolide

OBJECTIVE: To investigate the frequency of valvular heart disease in patients taking pergolide. PATIENTS AND METHODS: The medical records of patients seen at the Mayo Clinic in Jacksonville, Fla, between 1998 and 2003 were searched electronically for the word pergolide and the presence of a 2-dimensional echocardiogram. Patients who had not taken pergoilde before undergoing echocardiography served as the control group. Echocardiograms were reviewed for the presence of valvular regurgitation. The frequency of valvular disease in patients taking pergolide was calculated and compared with controls. Associations with dosage and years of treatment also were examined. RESULTS: Fifty-five patients made up the pergolide group, and 63 served as controls. When looking at aortic regurgitation (AR) of any degree, 45% of patients in the pergolide group had AR, compared with 21% of controls (P=.006). The frequency of moderate to severe valvular regurgitation in the pergolide group was 11% (95% confidence interval [Cl], 4%-22%),13% (95% Cl, 5% 24%), and 13% (95% Cl, 5%- 24%) for the tricuspid, mitral, and aortic valves, respectively. No statistical difference was identified in the frequency of moderate to severe valvular regurgitation (mitral, tricuspid, or aortic) when compared with controls. There was marginal evidence of an association between a higher daily dosage of pergolide and moderate to severe AR (P=.05). CONCLUSION: The frequency of AR appears to be increased In patients taking pergoilde. Our study suggests that if a cause effect relationship exists between pergolide and valvular heart disease, it likely occurs at a low but clinically important incidence and may be associated with dosage.