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

Abstract

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 therisk of heart failure. On the other hand, there are studies showing conflicting data about this relationship. The aim of the present study was toinvestigate 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 thepossible systolic dysfunction prior to the development of apparent systolic heart failure. Ninety-one (55 male, 64±10 years) patients with PD wereincluded in the study. Furthermore, 25 subjects with newly diagnosed PD and using no drug were enrolled as the control group. All patients weredivided 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 andstrain 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. Similarresults were obtained in strain analysis showing left ventricular subclinical dysfunction. Our study appears to confirm the safety of non-ergot DAin 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 ventricularsystolic function.