BACKGROUND: This study was undertaken to assess the effect of long-term beta-blockade on the aortic root stiffness index and distensibility in patients with Marfan syndrome. METHODS: Aortic root stiffness index and distensibility were calculated according to the formulas of Stefanadis and Hirai, respectively, with 2-dimensional guided M-mode echocardiogram before and after an average of 26 months of atenolol administration. RESULTS: Twenty-three asymptomatic patients were studied (11 men and 12 women, aged 31 +/- 14.2 years). The follow-up was 4 +/- 2.2 years. The dose of atenolol was individualized (mean 43.5 +/- 21.6 mg/d). Heart rate decreased from 79 +/- 9 beats/min to 64 +/- 9 beats/min (P =. 01), and systolic blood pressure decreased from 124 +/- 13 mm Hg to 114 +/- 2 mm Hg (P =.01). Distensibility increased from 1.85 +/- 0. 70 x 10(-6) cm2/dynes-1 to 2.21 +/- 0.76 x 10-6 cm2/dynes-1 (P =.02), and the stiffness index decreased from 9.68 +/- 3.78 to 8.85 +/- 3. 15 ( P =.2). Two groups of responses to treatment were identified. Compared with baseline values 15 (65%) patients who responded to treatment had increased distensibility and decreased stiffness index of the aortic root (P =.05). Eight patients (35%) who did not respond to treatment had no significant change. Body weight >91 kg and baseline end-diastolic aortic root diameter >40 mm were significantly associated with no response (P =.05). Two patients in the nonresponding group had echocardiographic progression of aortic insufficiency. CONCLUSIONS: There was a heterogeneous response in the aortic root elastic properties after long-term treatment with atenolol in asymptomatic patients with Marfan syndrome. Stiffness index and distensibility are more likely to respond when the baseline end-diastolic aortic root diameter is <40 mm.
BACKGROUND: This study was undertaken to assess the effect of long-term beta-blockade on the aortic root stiffness index and distensibility in patients with Marfan syndrome. METHODS: Aortic root stiffness index and distensibility were calculated according to the formulas of Stefanadis and Hirai, respectively, with 2-dimensional guided M-mode echocardiogram before and after an average of 26 months of atenolol administration. RESULTS: Twenty-three asymptomatic patients were studied (11 men and 12 women, aged 31 +/- 14.2 years). The follow-up was 4 +/- 2.2 years. The dose of atenolol was individualized (mean 43.5 +/- 21.6 mg/d). Heart rate decreased from 79 +/- 9 beats/min to 64 +/- 9 beats/min (P =. 01), and systolic blood pressure decreased from 124 +/- 13 mm Hg to 114 +/- 2 mm Hg (P =.01). Distensibility increased from 1.85 +/- 0. 70 x 10(-6) cm2/dynes-1 to 2.21 +/- 0.76 x 10-6 cm2/dynes-1 (P =.02), and the stiffness index decreased from 9.68 +/- 3.78 to 8.85 +/- 3. 15 ( P =.2). Two groups of responses to treatment were identified. Compared with baseline values 15 (65%) patients who responded to treatment had increased distensibility and decreased stiffness index of the aortic root (P =.05). Eight patients (35%) who did not respond to treatment had no significant change. Body weight >91 kg and baseline end-diastolic aortic root diameter >40 mm were significantly associated with no response (P =.05). Two patients in the nonresponding group had echocardiographic progression of aortic insufficiency. CONCLUSIONS: There was a heterogeneous response in the aortic root elastic properties after long-term treatment with atenolol in asymptomatic patients with Marfan syndrome. Stiffness index and distensibility are more likely to respond when the baseline end-diastolic aortic root diameter is <40 mm.
Authors: Gail D Pearson; Richard Devereux; Bart Loeys; Cheryl Maslen; Dianna Milewicz; Reed Pyeritz; Francesco Ramirez; Daniel Rifkin; Lynn Sakai; Lars Svensson; Andy Wessels; Jennifer Van Eyk; Harry C Dietz Journal: Circulation Date: 2008-08-12 Impact factor: 29.690
Authors: Syed Usman Bin Mahmood; Camilo A Velasquez; Mohammad A Zafar; Ayman A Saeyeldin; Adam J Brownstein; Bulat A Ziganshin; John A Elefteriades; Sandip K Mukherjee Journal: Ann Cardiothorac Surg Date: 2017-11
Authors: H H Clarice Yang; Jong Moo Kim; Elliott Chum; Cornelis van Breemen; Ada W Y Chung Journal: Br J Pharmacol Date: 2009-10-08 Impact factor: 8.739
Authors: Elif Seda Selamet Tierney; Jami C Levine; Lynn A Sleeper; Mary J Roman; Timothy J Bradley; Steven D Colan; Shan Chen; M Jay Campbell; Meryl S Cohen; Julie De Backer; Haleh Heydarian; Arvind Hoskoppal; Wyman W Lai; Aimee Liou; Edward Marcus; Arni Nutting; Aaron K Olson; David A Parra; Gail D Pearson; Mary Ella Pierpont; Beth F Printz; Reed E Pyeritz; William Ravekes; Angela M Sharkey; Shubhika Srivastava; Luciana Young; Ronald V Lacro Journal: Am J Cardiol Date: 2018-02-13 Impact factor: 2.778