[Aortic root dilatation rate in pediatric patients with Marfan syndrome treated with losartan].

Abstract

BACKGROUND:

Medical therapy with angiotensin II receptor blockers/angiotensin-converting enzyme inhibitors and/or beta-blockers was reported to reduce aortic root dilatation rates in pediatric patients with Marfan syndrome. No data are available in the literature on losartan effects after 3 years of therapy. The aim of our study was to establish whether losartan reduces aortic root dilatation rates in pediatric patients with Marfan syndrome in the mid and long term.

METHODS:

This is a retrospective analysis of 38 pediatric patients with Marfan syndrome followed at the Marfan Clinic of S. Orsola-Malpighi Hospital of the University of Bologna (Italy). Aortic diameters were measured at sinuses of Valsalva and proximal ascending aorta with transthoracic echocardiography.

RESULTS:

After a mean follow-up of 4.5 ± 2.5 years (range 2-9 years), aortic root z score at sinuses of Valsalva and proximal ascending aorta remained stable. The average annual rate of change in aortic root z score was -0.1 ± 0.4 and 0 ± 0.3 at sinuses of Valsalva and proximal ascending aorta, respectively. The mean dose of losartan was 0.7 ± 0.3 mg/kg/day. Three patients were non-responders, probably because of late beginning or low dose of therapy. Eight patients underwent cardiac surgery (aortic root surgery in 5 and mitral valve repair in 3), all of them started losartan later in life.

CONCLUSIONS:

Despite the retrospective design of the study and the small sample size, a beneficial effect of losartan therapy was observed in pediatric patients with Marfan syndrome in the mid and long term. Late beginning or low doses of losartan can turn off the effects of therapy.

• Authors: Elisabetta Mariucci, Marta Guidarini, Andrea Donti, Luigi Lovato, Anita Wischmeijer, Emanuela Angeli, Gaetano D Gargiulo, Fernando M Picchio, Marco Bonvicini
• Journal: Giornale italiano di cardiologia (2006) (G Ital Cardiol (Rome)) Vol. 16 Issue 12 Pg. 690-5 (Dec 2015) ISSN: 1827-6806 [Print] Italy
• Vernacular Title: Progressione della dilatazione aortica nel paziente pediatrico con sindrome di Marfan in terapia medica con losartan.
• PMID: 26667946 (Publication Type: Journal Article)

Chemical References

• Angiotensin II Type 1 Receptor Blockers
• Losartan

Topics

• Adolescent
• Angiotensin II Type 1 Receptor Blockers (therapeutic use)
• Aortic Valve
• Bicuspid Aortic Valve Disease
• Child
• Child, Preschool
• Dilatation, Pathologic (prevention & control)
• Female
• Heart Defects, Congenital (etiology, prevention & control)
• Heart Valve Diseases (etiology, prevention & control)
• Humans
• Losartan (therapeutic use)
• Male
• Marfan Syndrome (complications)
• Retrospective Studies