I am conducting a study into the need for echocardiogram monitoring in patients taking cabergoline for hyperprolactinaemia disorders (not Parkinson's disease). I'm interested if there are any local/national guidelines for echo surveillance that helps guide clinicians in this.
I think that such specific protocol does not exist yet. And for you it may be subject to explore and elaborate of dynamic ECHO valvular observation based on the following recommendations (files attached below).The echocardiographic assessment of valvular regurgitation should integrate the quantification of the regurgitation, assessment of the valve anatomy and function, as well as the consequences of valvular disease on cardiac chambers. The risk of valvular regurgitation appears to be greatest in patients who receive at least 3 mg cabergoline daily, and this dose is 10–20 times higher than that used for usual treatment of hyperprolactinaemia disorders (micro- or macroadenomas?). Patients who have demonstrated resistance to a dopamine agonist and who require very high daily doses should have an echocardiogram. In addition, because the risk of valvular disease in patients receiving long-term, low-dose dopamine agonist therapy is unknown, endocrinologists should discuss with each patient the potential risks of therapy and decide on the need for an echocardiogram on an individual basis.
Kind regards
Hi
As of i am aware, there is no specific monitoring protocol, however if we know the effects and and adverse effects of the drug (such as uncontrolled hypertensive changes and valvular dis integrity) then you can find the protocol in the resource section of European society of cardiology including national guidelines @ http://www.escardio.org/Guidelines/Clinical-Practice-Guidelines
Hope this is helpful
Regards
Victor
Hi both, Thank you for your informative answers. As you say it seems the evidence for echo monitoring in low dose cabergoline patients is limited. In Scotland echoes are done on an ad hoc basis influenced but the available SPC and society guidelines. We are currently working to standardise echo monitoring in these patients recommending low dose patients with normal CV examinations and no other risk factors would not normally require echo surveillance until a larger cumulative dose is reached
- Badges
- Science topic
- Similar topics
- Philosophy
- Moral Philosophy
- Free Will