The Relationship Between Long-Term Low-Dose Use of Cabergoline and Heart Valve Dysfunction in Pituitary Adenomas: A Retrospective Observational Study

Abstract

ABS TRACT Objective: Although it is known that cardiac dysfunction may develop due to long-term use of cabergoline at high doses, there is not enough information in the literature on low-dose use. In this study, we aimed to investigate the relationship between low-dose long-term use of cabergoline due to functional pituitary adenoma and heart valve dysfunction. Material and Methods: Patients using low-dose (0.5-1 mg/week) cabergoline for at least one year due to functional pi- tuitary adenoma (prolactinoma and acromegaly) were included in our study. Group 1A (n=50) with a diagnosis of prolactinoma who received cabergoline, Group 1B (n=47) of the healthy control group who did not receive it; Group 2A (n=29) diagnosed with acromegaly and receiving cabergoline was named as Group 2B (n=22) not receiving it. Subjects were evaluated by transthoracic echocardiography for heart valve fail- ure. Results: The incidence of mild heart valve failure was higher in Group 1A and Group 2A patients using cabergoline, while moderate and severe heart valve failure was not observed at all. The median cumulative dose of cabergoline was 169 mg [interquartile range (IQR), 104-377 mg] in Group 1A, compared to a median 310 mg (IQR, 208-572 mg) in Group 2A (p=0.009). In the Cox proportional hazard re- gression analysis created to predict heart valve failure, cumulative cabergoline dose was observed as the effective factor in univariant and multivariate analyzes [hazard ratio: 0.99 (95% confidence interval, 0.995-0.999), p<0.001; hazard ratio: 0.99 (95% confidence interval, 0.995-0.999), p=0.001]. Conclusion: Long-term use of low-dose cabergoline in pituitary adenomas may be associated with mild heart valvu- lar insufficiency.