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Background: Therapy with pergolide, an ergot-derived dopamine receptor agonist, is associated with retroperitoneal, pleural and pericardial fibrosis. The aim of this study was to investigate the relationship between the longterm use of pergolide and the prevalence of restrictive valvular heart disease. Methods: The study population consisted of 95 patients (age 61±9 years, 24% female) with Parkinson’s disease (PD) treated with pergolide and 35 healthy controls matched for age and gender. All subjects underwent transthoracic echo-Doppler examination. Valve morphology was graded as normal, restrictive or degenerative. Mitral valve tenting area and tenting distance were assessed from parasternal long-axis views. Results: Average daily dose of pergolide, cumulative dose and median duration of treatment were 2.93±0.72 mg, 4543±1932 mg and 51.6±23 months, respectively. Severe valvular heart disease or pulmonary hypertension was not observed in any subject. Two PD patients (2.1%) and one control (2.9%) had moderate degenerative aortic regurgitation. Discrete fibrous thickening of the left-sided valves was noted in 16 PD patients (16.8 %) as compared to none of the controls (p<0.01). Mitral valve was affected in 10 patients and aortic valve in 6 patients. Regurgitation was not observed on any of the affected valves. Of note, in the PD patients, the mitral valve tenting area was significantly larger than in controls (1.44±0.03 cm2 vs 1.05±0.05 cm2, p=0.0001). Conclusions: The present study demonstrated that long-term use of pergolide is not associated with clinically relevant valvular disease. Nevertheless, discrete fibrous changes with restrictive leaflet motion of left-sided valves were observed only in PD patients treated with pergolide.

european journal of echocardiography

419 Biological ring in mitral-valve repair: echocardiography evaluation of mitral annulus dysnamics and left-ventricular function with pericardial annuloplasty