Document Detail


Augmentation index and the evolution of aortic disease in marfan-like syndromes.
MedLine Citation:
PMID:  20395939     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The augmentation index at a heart rate of 75 beats/min (AIx@HR75) and central pulse pressure (CPP) can be measured noninvasively with applanation tonometry (APT). In this observational study, we investigated the relationship between AIx@HR75, CPP and aortic disease in patients with Marfan-like syndromes.
METHODS: We performed APT in 78 consecutive patients in whom classic Marfan syndrome (MFS) had been excluded (46 men and 32 women aged 34 +/- 13 years). These patients comprised 9 persons with MFS-like habitus, 6 with a bicuspid aortic valve (BAV), 5 with MASS phenotype, 3 with vascular type of Ehlers-Danlos syndrome (EDS), 3 with familial thoracic aortic aneurysm, 2 with Loeys-Dietz syndrome (LDS), 1 with mitral valve prolapse syndrome, 1 with familial ectopia lentis, and 48 persons with Marfan-like features but no defined syndrome. During 20 +/- 18 months after APT, we observed progression of aortic diameters in 15 patients, and aortic surgery or aortic dissection in 3 individuals.
RESULTS: All 11 patients with Marfan-like syndromes and progression of aortic disease exhibited AIx@HR75 > or =11%, including 8 individuals with aortic diameters < or =95th percentile of normal at baseline. Similarly, all 7 individuals without any defined syndrome but progression of aortic diameters exhibited AIx@HR75 >11%, including 6 individuals with aortic diameters < or =95th percentile at the time of APT. Aortic disease did not evolve at AIx@HR75 <11%. CPP is also related to aortic disease progression.
CONCLUSIONS: Aortic disease evolution relates to AIx@HR75 and CPP in Marfan like syndromes. Larger studies with comprehensive clinical and echocardiographic follow-up over long time intervals will be required to establish APT for prediction of aortic disease evolution in Marfan-like syndromes.
Authors:
Kai Mortensen; Johannes Baulmann; Meike Rybczynski; Sara Sheikhzadeh; Muhammet A Aydin; Henrik Treede; Ellen Dombrowski; Kristin Kühne; Philipp Peitsmeier; Christian R Habermann; Peter N Robinson; Manfred Stuhrmann; Jürgen Berger; Thomas Meinertz; Yskert von Kodolitsch
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Publication Detail:
Type:  Journal Article     Date:  2010-04-15
Journal Detail:
Title:  American journal of hypertension     Volume:  23     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-18     Completed Date:  2010-09-23     Revised Date:  2011-06-30    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  716-24     Citation Subset:  IM    
Affiliation:
Centre of Cardiology and Cardiovascular Surgery, University Hospital Eppendorf, Hamburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aneurysm, Dissecting / physiopathology
Aortic Aneurysm, Thoracic / physiopathology
Aortic Diseases / pathology,  physiopathology*
Blood Pressure*
Blood Pressure Determination
Disease Progression
Ectopia Lentis / physiopathology
Female
Heart Rate*
Hemodynamics*
Humans
Loeys-Dietz Syndrome / physiopathology
Male
Marfan Syndrome / physiopathology*
Mitral Valve Prolapse / physiopathology
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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