Key result
Beta-blockers and ARBs equally prevent aortic dilatation in Marfan syndrome, but CCBs may be detrimental.
Why the study?
Aortic dilatation, dissection, and rupture are major concerns in Marfan syndrome, necessitating evaluation of medical management strategies for thoracic aortic aneurysm disease.
Does medical management with beta-blockers or ARBs prevent aortic dilatation, dissection, and rupture in patients with Marfan syndrome?
Does medical management with beta-blockers or ARBs prevent aortic dilatation, dissection, and rupture in patients with Marfan syndrome?
This review elaborates on the current evidence for medical management of aortic disease in Marfan syndrome, highlighting beta-blockers as standard of care and ARBs as an emerging alternative.
Supports beta-blocker or ARB use in Marfan aortopathy; leaves open need for randomized trials to guide therapy.
Marfan syndrome (MFS) is a hereditary disorder with numerous pathophysiological effects, some specifically creating elastic dysfunction in cardiovascular organs. Aortic dilatation, dissection and rupture are major concerns in the management of MFS patients. Predilection to form aneurysms is an indication for prophylactic medical management of thoracic aortic aneurysm disease in these patients. The current guidelines describe β-blockers as the standard of care with angiotensin receptor blockers (ARBs) emerging as an equal, if not better alternative. We elaborate current evidence for and against different medical regimens used for the medical management of MFS patients.
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Mahmood et al. (2017) conducted a review in Marfan syndrome. Medical management (beta-blockers, ARBs) was evaluated. Beta-blockers remain the standard of care for preventing aortic dilatation in Marfan syndrome, with angiotensin receptor blockers emerging as an equally effective alternative, while calcium channel blockers may be detrimental.
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