Mayo Clinic researchers investigate drug's possible link to valvular heart disease

December 10, 2002

ROCHESTER, Minn. -- Mayo Clinic researchers are raising concerns about the potential association between the drug pergolide and valvular heart disease.

Pergolide mesylate is used to treat patients with Parkinson's disease and restless legs syndrome. To date, valvular heart disease has not been linked to patients using pergolide. However, in the current issue of Mayo Clinic Proceedings researchers describe three patients who were diagnosed as having valvular heart disease while receiving long-term pergolide therapy. The observations are similar to the findings in 1997 that were detected with fenfluramine and phentermine (fen-phen).

The physicians recommend that patients should discontinue taking pergolide if valvular disease is detected and no other cause identified. More studies are needed to determine the incidence of valvular disease and the spectrum of abnormalities seen with pergolide treatment.

"The clinical, echocardiographic and pathologic findings in our three patients suggest that pergolide treatment may cause valvular disease," said Raul Espinosa, M.D., of the Mayo Clinic Division of Cardiovascular Diseases and Internal Medicine and the principal author of the article.

In an accompanying editorial in Mayo Clinic Proceedings, Shahbudin Rahimtoola, M.B, FRCP, Distinguished Professor at the University of Southern California and professor of medicine at the Keck School of Medicine, outlines a potential study to ascertain the findings of the Mayo Clinic researchers. He said a well-designed prospective study should be conducted at three to four medical centers with experienced cardiologists and advanced laboratories and equipment. Ideally, Dr. Rahimtoola said the patients should undergo clinical cardiac evaluation (history, physical examination, electrocardiography, chest radiography) and two-dimensional echocardiographic and Doppler studies.

And although he said that further study is needed, the findings, thus far, are important. "Is the association with use of the drug real? Yes, until proven otherwise," said Dr. Rahimtoola. "One could argue that this is a report of only three patients and that we should wait for more cases; however, try telling that to patients and families of those who subsequently develop valvular heart disease that requires valve replacement."

The three patients that Mayo physicians examined had leaking or backward flow in the tricuspid valve in the heart. The tricuspid valve separates the right atrium from the right ventricle and prevents blood from flowing back into the right atrium during contraction of the ventricle. The patients were examined from September 2000 to April 2002 at Mayo Clinic in Rochester, Minn. The patients -- all women, ages 61, 72 and 74 -- were not taking any other drugs that have been found to produce similar valvular disease. And all three were taking pergolide. The first two patients also had moderate aortic and mitral regurgitation.
Other physicians who assisted Dr. Espinosa in the article are: Allison Pritchett, M.D., John Morrison, M.D., and Heidi Connolly, M.D., of the Mayo Clinic Division of Cardiovascular Diseases and Internal Medicine; William Edwards, M.D., of the Mayo Clinic Division of Anatomic Pathology; and Hartzell Schaff, M.D., of the Mayo Clinic Division of Cardiovascular Surgery.

Mayo Clinic Proceedings is a peer-reviewed and indexed general internal medicine journal, published for more than 75 years by Mayo Foundation, with a circulation of 130,000 nationally and internationally.

To obtain the latest news releases from Mayo Clinic, go to ( is available as a resource for your health stories.

Mayo Clinic

Related Mayo Clinic Articles from Brightsurf:

Mayo Clinic-led study links obesity with pancreatitis
A study by researchers at Mayo Clinic in Arizona published in the The Journal of Clinical Investigation has found that obesity is not only implicated in chronic diseases such as diabetes, but also in sudden-onset diseases such as pancreatitis.

Mayo Clinic researchers clarify how cells defend themselves from viruses
A protein known to help cells defend against infection also regulates the form and function of mitochondria, according to a new paper in Nature Communications.

Mayo Clinic study looks at changes in outcomes for coronary revascularization
The most common type of heart disease -- coronary artery disease -- affects 6.7% of adults and accounts for 20% of 2 in 10 deaths of adults under age 65.

Mayo Clinic researchers review modern cases of leprosy
Leprosy has a history that has spanned centuries and societies across the globe.

Kidney stones on the rise, Mayo Clinic study finds
Kidney stones are a painful health condition, often requiring multiple procedures at great discomfort to the patient.

Mayo Clinic researchers demonstrate value of second opinions
Many patients come to Mayo Clinic for a second opinion or diagnosis confirmation before treatment for a complex condition.

Mayo Clinic researchers clarify chemo resistance, and perhaps a new therapy
Mayo Clinic scientists have identified a specific protein implicated in drug resistance, as well as a possible therapeutic tool.

Mayo Clinic researchers identify therapy
Mayo Clinic researchers have found that an experimental drug, LCL161, stimulates the immune system, leading to tumor shrinkage in patients affected by multiple myeloma.

Mayo Clinic researchers uncover new agents
Mayo Clinic researchers have uncovered three new agents to add to the emerging repertoire of drugs that aim to delay the onset of aging by targeting senescent cells -- cells that contribute to frailty and other age-related conditions.

Mayo Clinic: Reversing physician burnout, using nine strategies to promote well-being
Researchers at Mayo Clinic have been documenting the rise and costs of physician burnout for more than a decade.

Read More: Mayo Clinic News and Mayo Clinic Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to