Parkinson's Disease and Allied Conditions - Review Article

Journal of Neural Transmission

, Volume 116, Issue 2, pp 179-191

First online:

Risk of valvular heart disease associated with the use of dopamine agonists in Parkinson’s disease: a systematic review

  • Malcolm SteigerAffiliated withThe Walton Centre for Neurology and Neurosurgery Email author 
  • , W. JostAffiliated withDepartment of Neurology, German Diagnostic Clinic
  • , F. GrandasAffiliated withDepartment of Neurology, Hospital Gregorio Marañón
  • , G. Van CampAffiliated withAcademic Hospital

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A literature review was conducted to assess risk of cardiac valve regurgitation (CVR) associated with use of ergot-derived and non-ergot dopamine agonists (DAs) in patients with Parkinson’s disease (PD). Inclusion criteria: case-control/observational studies of >10 patients with PD treated with DAs, including a control group and assessment of incidence/risk of CVR. Of the 166 publications identified, 14 met all inclusion criteria and included 1,750 patients. In 11 of the studies, a significant increase in CVR frequency of any severity (at the aortic, mitral or tricuspid valve) in the ergot group vs. the non-ergot or control group was described. No study reported increased risk of CVR for non-ergot DAs, compared with controls. In the studies identified in the literature, the use of ergot-derived DAs (pergolide and cabergoline) in patients with PD was associated with increased risk of CVR. Increased risk of CVR was not associated with the use of non-ergot DAs.


Cardiac valve regurgitation Parkinson’s disease Dopamine agonists Valvular heart disease