Effect of long-term beta-blockade on aortic root compliance in patients with Marfan syndrome.

Abstract

BACKGROUND:

This study was undertaken to assess the effect of long-term beta-blockade on the aortic root stiffness index and distensibility in patients with Marfan syndrome.

METHODS:

Aortic root stiffness index and distensibility were calculated according to the formulas of Stefanadis and Hirai, respectively, with 2-dimensional guided M-mode echocardiogram before and after an average of 26 months of atenolol administration.

RESULTS:

Twenty-three asymptomatic patients were studied (11 men and 12 women, aged 31 +/- 14.2 years). The follow-up was 4 +/- 2.2 years. The dose of atenolol was individualized (mean 43.5 +/- 21.6 mg/d). Heart rate decreased from 79 +/- 9 beats/min to 64 +/- 9 beats/min (P =. 01), and systolic blood pressure decreased from 124 +/- 13 mm Hg to 114 +/- 2 mm Hg (P =.01). Distensibility increased from 1.85 +/- 0. 70 x 10(-6) cm2/dynes-1 to 2.21 +/- 0.76 x 10-6 cm2/dynes-1 (P =.02), and the stiffness index decreased from 9.68 +/- 3.78 to 8.85 +/- 3. 15 ( P =.2). Two groups of responses to treatment were identified. Compared with baseline values 15 (65%) patients who responded to treatment had increased distensibility and decreased stiffness index of the aortic root (P =.05). Eight patients (35%) who did not respond to treatment had no significant change. Body weight >91 kg and baseline end-diastolic aortic root diameter >40 mm were significantly associated with no response (P =.05). Two patients in the nonresponding group had echocardiographic progression of aortic insufficiency.

CONCLUSIONS:

There was a heterogeneous response in the aortic root elastic properties after long-term treatment with atenolol in asymptomatic patients with Marfan syndrome. Stiffness index and distensibility are more likely to respond when the baseline end-diastolic aortic root diameter is <40 mm.

• Authors: A S Rios, E N Silber, N Bavishi, P Varga, B K Burton, W A Clark, P Denes
• Journal: American heart journal (Am Heart J) Vol. 137 Issue 6 Pg. 1057-61 (Jun 1999) ISSN: 0002-8703 [Print] United States
• PMID: 10347331 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Adrenergic beta-Antagonists
• Atenolol

Topics

• Adrenergic beta-Antagonists (pharmacology, therapeutic use)
• Adult
• Aorta (drug effects, physiopathology)
• Aortic Valve (drug effects, physiopathology)
• Atenolol (pharmacology, therapeutic use)
• Chi-Square Distribution
• Compliance (drug effects)
• Echocardiography (drug effects)
• Electrocardiography (drug effects)
• Female
• Humans
• Male
• Marfan Syndrome (drug therapy, physiopathology)
• Middle Aged
• Time Factors
• Vascular Capacitance (drug effects, physiology)