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Bromocriptine is a semi-synthetic ergot alkaloid derivative that acts as a potent dopamine D2 receptor agonist and a partial D1 receptor antagonist. Traditionally indicated for the treatment of Parkinson's disease, hyperprolactinemia-associated dysfunctions (such as amenorrhea and infertility), and acromegaly, it has more recently been investigated for its role in peripartum cardiomyopathy (PPCM). In PPCM, bromocriptine is used to suppress prolactin secretion from the pituitary gland. This therapeutic approach is based on the pathophysiology where oxidative stress leads to the cleavage of the 23-kDa prolactin molecule into a 16-kDa fragment that is angiostatic and pro-apoptotic, causing myocardial damage. The PolBrom-PPCM trial, conducted by the Cardinal Stefan Wyszyński Institute of Cardiology, specifically evaluates the efficacy of intensified bromocriptine dosing regimens in improving left ventricular recovery in affected women.
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