Retrospective analysis of the effect of angiotensin II receptor blocker versus β-blocker on aortic root growth in paediatric patients with Marfan syndrome
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Retrospective analysis of the effect of angiotensin II receptor blocker versus β-blocker on aortic root growth in paediatric patients with Marfan syndrome. / Mueller, Goetz C; Stierle, Lydia; Stark, Veronika; Steiner, Kristoffer; von Kodolitsch, Yskert; Weil, Jochen; Mir, Thomas S.
In: HEART, Vol. 100, No. 3, 02.2014, p. 214-218.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Retrospective analysis of the effect of angiotensin II receptor blocker versus β-blocker on aortic root growth in paediatric patients with Marfan syndrome
AU - Mueller, Goetz C
AU - Stierle, Lydia
AU - Stark, Veronika
AU - Steiner, Kristoffer
AU - von Kodolitsch, Yskert
AU - Weil, Jochen
AU - Mir, Thomas S
PY - 2014/2
Y1 - 2014/2
N2 - OBJECTIVES: Cardiovascular pathology, including aortic root dilation at the level of sinus of Valsalva (SV), is one of the major causes of morbidity in paediatric patients with Marfan syndrome (MFS). β-Blocker (BB) is well established to slow aortic dilation in MFS. Less is known about the effectiveness of angiotensin II receptor blocker (ARB) on aortic dilation in paediatric patients with MFS.METHODS: 215 patients with MFS (9.01 ± 5.7 years) were subject to a standardised diagnostic programme. Aortic root dilation was evaluated and followed up by echocardiography. In 48 cases, BB and ARB effects on aortic root dilation were evaluated. Effect of treatment was measured by comparison of z scores of SV before and after treatment initiation.RESULTS: Treatment by ARB and BB leads to significant reduction of SV dilation (p<0.05). The deviation of SV enlargement from normal as expressed by the rate of change in z scores was significantly reduced by a mean difference of -0.56 ± 0.71 z scores (p<0.001) under ARB therapy and by a mean difference of -0.35 ± 0.68 z scores (p<0.05) under BB therapy. The prophylactic effect of ARB and BB on aortic root dilation is similar in both groups (p>0.05).CONCLUSIONS: Both concepts lead to a significant reduction of SV dilation. The effect of ARB and BB is similar. This is the first study concerning the comparison of ARB and BB in previously untreated paediatric patients with MFS. The results of the study show that both treatment strategies are beneficial in paediatric and adolescent patients.
AB - OBJECTIVES: Cardiovascular pathology, including aortic root dilation at the level of sinus of Valsalva (SV), is one of the major causes of morbidity in paediatric patients with Marfan syndrome (MFS). β-Blocker (BB) is well established to slow aortic dilation in MFS. Less is known about the effectiveness of angiotensin II receptor blocker (ARB) on aortic dilation in paediatric patients with MFS.METHODS: 215 patients with MFS (9.01 ± 5.7 years) were subject to a standardised diagnostic programme. Aortic root dilation was evaluated and followed up by echocardiography. In 48 cases, BB and ARB effects on aortic root dilation were evaluated. Effect of treatment was measured by comparison of z scores of SV before and after treatment initiation.RESULTS: Treatment by ARB and BB leads to significant reduction of SV dilation (p<0.05). The deviation of SV enlargement from normal as expressed by the rate of change in z scores was significantly reduced by a mean difference of -0.56 ± 0.71 z scores (p<0.001) under ARB therapy and by a mean difference of -0.35 ± 0.68 z scores (p<0.05) under BB therapy. The prophylactic effect of ARB and BB on aortic root dilation is similar in both groups (p>0.05).CONCLUSIONS: Both concepts lead to a significant reduction of SV dilation. The effect of ARB and BB is similar. This is the first study concerning the comparison of ARB and BB in previously untreated paediatric patients with MFS. The results of the study show that both treatment strategies are beneficial in paediatric and adolescent patients.
KW - Adolescent
KW - Adrenergic beta-1 Receptor Antagonists/therapeutic use
KW - Age Factors
KW - Angiotensin II Type 1 Receptor Blockers/therapeutic use
KW - Aortic Diseases/drug therapy
KW - Child
KW - Child, Preschool
KW - Dilatation, Pathologic/drug therapy
KW - Female
KW - Humans
KW - Male
KW - Marfan Syndrome/complications
KW - Metoprolol/therapeutic use
KW - Retrospective Studies
KW - Tetrazoles/therapeutic use
KW - Treatment Outcome
KW - Valine/analogs & derivatives
KW - Valsartan
U2 - 10.1136/heartjnl-2013-304946
DO - 10.1136/heartjnl-2013-304946
M3 - SCORING: Journal article
C2 - 24270746
VL - 100
SP - 214
EP - 218
JO - HEART
JF - HEART
SN - 1355-6037
IS - 3
ER -
