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NEUROLOGY 2009;72:621-626
© 2009 American Academy of Neurology

B-type natriuretic peptide and cardiovalvulopathy in Parkinson disease with dopamine agonist

H. Watanabe, MD, M. Hirayama, MD, A. Noda, PhD, M. Ito, MD, N. Atsuta, MD, J. Senda, MD, T. Kaga, MD, A. Yamada, MD, M. Katsuno, MD, T. Niwa, MD, F. Tanaka, MD and G. Sobue, MD

From the Departments of Neurology (H.W., M.H., M.I., N.A., J.S., T.K., M.K., F.T., G.S.) and Cardiology (A.Y.), Nagoya University Graduate School of Medicine; and Departments of Medical Technology (A.N.) and Clinical Preventive Medicine (T.N.), Nagoya University School of Health Sciences, Japan.

Address correspondence and reprint requests to Dr. Gen Sobue, Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan sobueg{at}med.nagoya-u.ac.jp

Objective: To elucidate the usefulness of plasma B-type natriuretic peptide (BNP) values for evaluating adverse effects of pergolide or cabergoline on cardiovalvulopathy in patients with Parkinson disease.

Methods: Twenty-five patients treated with pergolide or cabergoline (ergot group) and 25 patients never treated with ergot derivatives (non-ergot group) were enrolled. Plasma BNP values and detailed echocardiography were evaluated. Thirty age- and gender-matched controls were similarly evaluated.

Results: Patients with regurgitation more than grade 3 were more frequent in the ergot group than in the non-ergot group as well as control groups (24%, 0%, 3%, p = 0.001). Both composite regurgitation scores and plasma BNP values were significantly higher in the ergot group than in controls. In the ergot group, the cumulative dose correlated to both tenting area (r = 0.57, p = 0.004) and tenting distance (r = 0.62, p = 0.001). Furthermore, plasma BNP values were higher in patients with severe or multiple regurgitation groups (p < 0.001), and were correlated with composite regurgitation score (r = 0.70, p < 0.001). Multiple regression analyses revealed that BNP values were independently correlated with both composite regurgitation and left ventricular ejection fraction.

Conclusion: The combination of comprehensive echocardiography and plasma B-type natriuretic peptide levels elucidates the presence of cardiac damage in patients with Parkinson disease using ergot derivative dopamine agonists.

Abbreviations: AR = aortic regurgitation; BNP = B-type natriuretic peptide; MR = mitral regurgitation; PD = Parkinson disease; TR = tricuspid regurgitation; UPDRS = Unified Parkinson's Disease Rating Scale.

Supported by Health and Labor Sciences Research grants for research on measures for intractable diseases and comprehensive research on Aging and Health of the Ministry of Health, Labor and Welfare, Japan.

Disclosure: The authors report no disclosures.

Received May 23, 2008. Accepted in final form November 17, 2008.






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