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Evaluation of the effect of non-ergot dopamine agonists on left ventricular systolic function with speckle tracking echocardiography [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-65983 | DOI: 10.14744/AnatolJCardiol.2018.65983  

Evaluation of the effect of non-ergot dopamine agonists on left ventricular systolic function with speckle tracking echocardiography

Hilal Erken Pamukcu1, Demet Menekşe Gerede Uludağ2, Bahar Tekin Tak3, Mine Hayriye Sorgun4, Tolga Han Efe1, Aynur Acıbuca2, Cenk Akbostancı4, Sibel Turhan2
1Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital; Ankara-Turkey
2Department of Cardiology, Türkiye Yüksek İhtisas Training and Research Hospital; Ankara-Turkey
3Department of Cardiology, Ankara University Faculty of Medicine; Ankara-Turkey
4Department of Neurology, Ankara University Faculty of Medicine; Ankara-Turkey

Objective: Parkinson's disease (PD) is a neurological disorder, and ergot dopamine agonists (DAs) are no longer usually preferred in the treatment due to the increased risk of valvular heart disease. Some recent studies have shown that commonly used non-ergot DA also increases the risk of heart failure. On the other hand, there are studies showing conflicting data about this relationship. The aim of the present study was to investigate the cardiac effects of non-ergot DAs in patients with PD using echocardiography.
Methods: Conventional echocardiography and two-dimensional (2D) speckle tracking strain echocardiography were performed to determine the
possible systolic dysfunction prior to the development of apparent systolic heart failure. Ninety-one (55 male, 64±10 years) patients with PD were included in the study. Furthermore, 25 subjects with newly diagnosed PD and using no drug were enrolled as the control group. All patients were divided into groups according to their medication. Patients using levodopa were classified as Group 1 (36), levodopa+pramipexole as Group 2 (27), and levodopa+ropinirole as Group 3 (28).
Results: Left ventricle dysfunction with non-ergot DA use in patients with PD was not established with conventional echocardiographic evaluation. For 2D strain analysis, global longitudinal strain values were obtained as −18.5%, −18.5%, and −18.9% in the groups, respectively. Strain and strain rate values of the left ventricle were not different between the groups (p=0.816 and p=0.881, respectively).
Conclusion: There was no significant relationship between left ventricular dysfunction and use of non-ergot DA in patients with PD. Similar
results were obtained in strain analysis showing left ventricular subclinical dysfunction. Our study appears to confirm the safety of non-ergot DA
in the point of heart failure risk. To our knowledge, this is the first study to evaluate the effect of this group of drugs on subclinical left ventricular
systolic function.

Keywords: Parkinson’s disease, non-ergot dopamine agonist, speckle tracking echocardiography, strain echocardiography

Corresponding Author: Hilal Erken Pamukcu, Türkiye

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