Document Detail

Determinants of rapid progression of aortic root dilatation and complications in Marfan syndrome.
MedLine Citation:
PMID:  16321689     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Progressive aortic dilatation has prognostic significance in the Marfan syndrome. METHODS: To identify which patients were at high risk of rapid progression, we echocardiographically studied 43 patients (age 22 +/- 14 years) with the mean follow-up period of 5.2 +/- 3.2 years. Aortic diameters, left ventricular (LV) size, fractional shortening, and the severity of aortic and mitral regurgitation were assessed. Transmitral peak early and atrial flow velocities, their ratio and the deceleration time of peak early velocity were also obtained. RESULTS: Mean annual increases of aortic diameters were 0.4 +/- 0.3 mm at the annulus, 1.5 +/- 1.3 mm at the sinuses of Valsalva, 0.7 +/- 0.6 mm at the supraaortic ridge and 0.4 +/- 0.4 mm at the proximal ascending aorta. Patients were divided into 2 groups according to the aortic growth rate at the sinuses of Valsalva level: rapid (R, >3% per year, 15 patients) or slow (S, < or =3% per year, 28 patients) progression groups. Measured variables did not show significant differences between the 2 groups except older age, higher blood pressure and more severe aortic regurgitation in group R. Multiple regression analysis identified prolonged deceleration time as the most important variable predicting aortic complications. Aortic dissection occurred more frequently in group R (7 patients, 47%) than in group S (0%, P < 0.001). CONCLUSIONS: Marfan patients at older age, with higher blood pressure, and with significant aortic regurgitation were at high risk of progression of aortic dilatation, with the most remarkable increase at the sinuses of Valsalva. Prolonged deceleration time may relate to an increased risk for aortic complications.
Aleksandar M Lazarevic; Satoshi Nakatani; Yutaka Okita; Jelena Marinkovic; Yutaka Takeda; Keiji Hirooka; Hiroshi Matsuo; Soichiro Kitamura; Masakazu Yamagishi; Kunio Miyatake
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of cardiology     Volume:  106     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-02     Completed Date:  2006-03-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  177-82     Citation Subset:  IM    
Department of Cardiology, National Cardiovascular Center, Suita, Osaka, Japan.
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MeSH Terms
Aortic Diseases / etiology*,  physiopathology*,  ultrasonography
Child, Preschool
Dilatation, Pathologic
Disease Progression
Marfan Syndrome / complications*,  physiopathology*,  ultrasonography
Middle Aged
Regression Analysis
Retrospective Studies

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