Losartan Added to β-Blockade Therapy for Aortic Root Dilation in Marfan Syndrome: A Randomized, Open-Label Pilot Study

Chiu, H. H.; Wu, Mei‐Hwan; Wang, Jou‐Kou; Lu, Chun‐Wei; Chiu, Shuenn–Nan; Chen, Chun-An; Lin, Min; Hu, Fang

doi:10.1016/j.mayocp.2012.11.005

Cited by 155 publications

(107 citation statements)

References 19 publications

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“…In addition, these pathogenetic insights have delivered new treatment options (i.e. angiotensin receptor blockers, which are antagonists of TGF-β signaling pathway, to reduce aorta dilatation), that are currently investigating in large clinical trials [21][22][23]. On the other hand, this is suggested by 2014 ESC guidelines [4].…”

Section: Introductionmentioning

confidence: 99%

Genetic contribution in sporadic thoracic aortic aneurysm? Emerging evidence of genetic variants related to TLR-4-mediated signaling pathway as risk determinants

Balistreri

2015

Vascular Pharmacology

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Keywords:Sporadic thoracic aortic aneurysms (TAA) and dissections Genetic variants Biomarkers Targets for new personalized therapeutic treatments Sporadic thoracic aortic aneurysms (TAA) and dissections are one of the major causes of morbidity and mortality worldwide, especially in those older than 65 years. The presentation of TAA is varied and often silent. Thus, sporadic TAA detection is often fortuitous, with identification occurring during a routine physical examination or during an unrelated medical evaluation. Once suspected, confirmation by imaging clinical approaches is needed to allow the choose of the unique treatments for TAA, namely the surgery procedures, including elective surgery or endovascular repair before the onset of catastrophic and fatal complications, such as dissection or rupture. At present, there are no biomarkers available to identify TAAs before visible symptoms. However, recent progresses in understanding of molecular and cellular mechanisms involved in the patho-physiology of sporadic TAA are suggesting different molecular pathways and their genetic variants as potential biomarkers, which might be applied into TAA clinical practice in the near future. Here, we report literature evidence on some disease pathways and their genetic variants on TAA susceptibility and compliances, and their translation as promising TAA preventive and prognostic biomarkers and targets for new personalized therapeutic treatments.

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Section: Introductionmentioning

confidence: 99%

Genetic contribution in sporadic thoracic aortic aneurysm? Emerging evidence of genetic variants related to TLR-4-mediated signaling pathway as risk determinants

Balistreri

2015

Vascular Pharmacology

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“…Основ-ной целью медикаментозного терапии при заболева-ниях аорты является снижение стресса сосудистой стенки пораженного сегмента аорты путем контроля артериального давления и сократительной функции сердца. Согласно литературным данным, пациентам с синдромом Марфана показано назначение бета-блокаторов, ингибиторов ангиотензин-превращаю-щего фермента и блокаторов рецепторов к ангио-тензину II типа [19][20]. Среди наших пациентов наличие АГ в послеоперационном периоде на яви-лось дополнительным фактором риска развития аневризм ТаАо (p=0,22).…”

Section: Discussionunclassified

The Condition of Distal Aorta After Proximal Reconstruction for Dissection in Marfan Syndrome

Чернявский¹,

Ляшенко²,

Сирота³

et al. 2016

Russ J Cardiol

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Marfan syndrome is a disease associated with high prevalence of aorta-related morbidity and mortality. Dissections and ruptures of thoracal aorta (ThAo) lead to decreased life duration in persons with Marfan syndrome with mediana at 30 year-old. Aim. To study the changes of distal aorta and clinical outcomes after surgical treatment for proximal aorta dissection in Marfan syndrome. Material and methods. In the SRICP, among patients operated for proximal aorta dissection, 14 were selected, who had histologically proven Marfan syndrome. They were followed-up. Results. In the long-term follow-up after the intervention on thoracoabdominal aorta (TAAo) was required in 2 patients. Reasons for transforming of the distal aorta were the age of the disease onset (p=0,04), acute stage of dissection (p=0,02). Changes in TAAo developed during first months after primary intervention, as in several years. Conclusion.Surgery for proximal dissections in Marfan syndrome patients is related to acceptable levels of morbidity and mortality in early and post-operation periods. Regular follow-up is required of such patients in post-operation period for on-time diagnostics and performing of secondary interventions.Russ J Cardiol 2016, 11 (139): 7-11 http://dx

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“…Current clinical studies have elucidated an optimal medical regimen for patients with MFS that may control the progression of cardiovascular manifestations and reduce the mortality associated with them (5,(10)(11)(12)(13)(14). The standard of care for medical management constitutes the use of β-blockers with supplementation or replacement by angiotensin receptor blockers (ARBs), although this is a subject of ongoing research (5).…”

Section: Medical Management In Mfsmentioning

confidence: 99%

“…Currently, β-blockers are the preferred method of management, with ARBs emerging as an equally effective strategy. B-blockers, ARBs and statins when combined, may potentially have an additive beneficial effect on decreasing the rate of progression of aortic aneurysms, although this theory needs further evaluation (14). While all MFS patients have a predisposition to develop thoracic aortic aneurysm and dissection, the decision to initiate longterm medical management with anti-hypertensives should be individualized to the patient, as benefit is unproven.…”

Section: Current Practice and Future Perspectivesmentioning

confidence: 99%

Medical management of aortic disease in Marfan syndrome

Mahmood

Velásquez

Zafar

et al. 2017

Ann. Cardiothorac. Surg.

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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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Losartan Added to β-Blockade Therapy for Aortic Root Dilation in Marfan Syndrome: A Randomized, Open-Label Pilot Study

Cited by 155 publications

References 19 publications

Genetic contribution in sporadic thoracic aortic aneurysm? Emerging evidence of genetic variants related to TLR-4-mediated signaling pathway as risk determinants

Genetic contribution in sporadic thoracic aortic aneurysm? Emerging evidence of genetic variants related to TLR-4-mediated signaling pathway as risk determinants

The Condition of Distal Aorta After Proximal Reconstruction for Dissection in Marfan Syndrome

Medical management of aortic disease in Marfan syndrome

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