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From the University of Texas Southwestern Medical School (D.G. Baseman) and Departments of Neurology (Drs. O’Suilleabhain and Dewey) and Internal Medicine (Division of Cardiology) (Drs. Reimold and Laskar), University of Texas Southwestern Medical Center, Dallas, and Department of Epidemiology (J.G. Baseman), University of Washington, Seattle.
Address correspondence and reprint requests to Dr. R.B. Dewey, Jr., Department of Neurology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9036; e-mail: richard.dewey{at}utsouthwestern.edu
Objective: To determine if pergolide injures heart valves, by comparing echocardiographic findings in pergolide-treated patients with those of a historical control group.
Methods: Letters were sent to all patients in the authors’ practice believed to be taking pergolide, and those responders who wished to continue it were urged to undergo echocardiography. Echocardiograms were obtained on 46 patients, and scores for valvular regurgitation were compared with those from an age-matched control group derived from the Framingham Study. The composite valve regurgitation score was modeled as a linear function of total milligrams lifetime use of pergolide, controlling for age.
Results: Eighty-nine percent of pergolide-treated patients had some degree of valvular insufficiency. For each of the three valves for which there are control data, we found an approximately 2- to 3-fold increased risk of abnormal valves in the pergolide patients (odds ratio [OR] 
3) and an estimated 14-fold increased risk of concerning tricuspid regurgitation (OR = 18.4). The composite valve score (the sum of valve scores for each of the four valves) was a function of lifetime pergolide use.
Conclusion: Pergolide may injure cardiac valves, resulting most commonly in tricuspid regurgitation.
Received December 13, 2003. Accepted in final form March 8, 2004.
Drs. Dewey and O’Suilleabhain have received honoraria for speaker programs from GlaxoSmithKline and Pfizer, makers of nonergot dopamine agonists. Dr. Reimold has received honoraria for speaker programs from Pfizer.
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