Drugs to treat Parkinson’s disease may be safe for heart

Non-ergot-derived dopamine agonists, a class of drugs used to treat Parkinson’s disease, did not affect left ventricular longitudinal contractility in a preliminary study.

According to the study background, ergot-derived dopamine agonists were withdrawn from the market after being associated with fibrotic heart valve disease, and there have been reports, including a public advisory notice from the FDA, that the non-ergot-derived dopamine agonist pramipexole (Mirapex, Mirapexin or Sifrol; Boehringer Ingelheim) may increase risk for HF.

Researchers for the new study used 2-D strain echocardiography to examine LV longitudinal contractility in 55 patients with Parkinson’s disease (mean age, 63 years), applying 2-D longitudinal strain analysis with the speckle tracking method.

Eighteen patients using pramipexole plus levodopa and 13 patients using ropinirole, another non-ergot-derived dopamine agonist, plus levodopa were compared with 24 patients using levodopa alone who did not have any cardiac adverse effects. The groups were similar in age, sex and hypertension status.

In a presentation at EuroEcho Imaging, Hilal Erken Pamukcu, MD, reported no between-group differences in global longitudinal strain values (levodopa, –17.51%; levodopa-pramipexole, –17.56%; levodopa-ropinirole, –17.3%; P=.781).

She also reported no difference in global longitudinal strain rates (levodopa group, –1.03; levodopa-pramipexole group, –1.02%; levodopa-ropinirole group, –0.98%; P=.649).

“We did not detect any evidence of asymptomatic myocardial dysfunction or deterioration of systolic function in patients taking pramipexole or ropinirole,” Erken Pamukcu, cardiologist at Ankara Diskapi Education and Research Hospital, Turkey, said in a press release. As we did not show any statistically significant myocardial dysfunction in the groups taking pramipexole or ropinirole, our study suggests that these drugs do not cause heart damage. Our conclusion from this small, preliminary study is that non-ergot-derived dopamine agonists are safe for the heart.”

According to Erken Pamukcu and colleagues, this is the first study to assess LV function using 2-D strain echocardiography in Parkinson’s disease patients taking non-ergot-derived dopamine agonists, and larger studies are needed to confirm the results.

For more information:

Erken Pamukcu H. Abstract #P466. Presented at: EuroEcho-Imaging 2014; Dec. 3-6, 2014; Vienna.

Disclosure: Cardiology Today could not obtain relevant financial disclosures.