Session: OR27-Pituitary: Acromegaly and Prolactinoma
Room 135 (Moscone Center)
Aim: To compare the findings on clinical cardiovascular examination with transthoracic echocardiography in patients with prolactinoma treated with cabergoline for >1 year.
Methods: 40 consecutive cases (48% female, mean age 39.6 yrs and 52% males, mean age 48.9 yrs) of prolactinoma on cabergoline underwent cardiovascular examination by their treating endocrinologist during a routine clinic visit, followed by echocardiogram at a single centre. Transthoracic echocardiograms were undertaken on a single machine and reported unblinded by a cardiologist (DP).
Results: 28/40 (70%) cases had macroprolactinomas. Previous bromocriptine treatment was used in 7/40 cases. Duration of cabergoline therapy of 71.2 months (range 50-92), with cumulative doses of 389±169 mg females and 393±55 mg males. Comorbidities: hypertension 10%, diabetes 5% and hyperlipidaemia 5%. On history, only 1 case reported symptoms suggestive of cardiac disease (dyspnoea on extreme exertion).
Cardiovascular examination: 4/40 (10%) had an audible systolic murmur, all graded 2/6 with normal heart sounds. 4/40 (10%) were hypertensive (≥150/90 mmHg), 6/40 (15%) hypotensive (<100 mmHg systolic).
Echocardiogram findings: No moderate-severe valvular lesions were found. There were 4 cases of age related aortic sclerosis and 2 cases myxomatous disease of the mitral valve. No cases of fibrotic valvular thickening were identified. The 4 cases with an audible murmur did not have valvular abnormalities.
Conclusion: This study further confirms that cabergoline used for prolactinomas is rarely associated with clinical relevant valvular disease. Echocardiogram cannot be justified as a routine screening tool for valvular disease in all patients. We suggest targeting three groups for echocardiographic evaluation – patients with an audible murmur on clinical examination, patients with resistant prolactinomas on high doses of cabergoline and patients >65 years who have a higher background risk of valvular abnormalities.
Nothing to Disclose: CC, DLP, WJI
*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm
See more of: Abstracts - Orals, Featured Poster Presentations, and Posters