Losartan reduces aortic dilatation rate in adults with Marfan syndrome: a randomized controlled trial
Maarten Groenink,Alexander W. den Hartog,Romy Franken,Teodora Radonic,Vivian de Waard,Janneke Timmermans,Arthur J. Scholte,Maarten P. van den Berg,Anje M. Spijkerboer,Henk A. Marquering,Aeilko H. Zwinderman,Barbara J.M. Mulder +11 more
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In adult Marfan patients, losartan treatment reduces aortic root dilatation rate and in patients with prior aortsic root replacement, aorti arch dilatant rate was significantly lower in the losartsan group when compared with the control group.Abstract:
Aim Patients with Marfan syndrome have an increased risk of life-threatening aortic complications, mostly preceded by aortic dilatation. Treatment with losartan, an angiotensin-II receptor-1 blocker, may reduce aortic dilatation rate in Marfan patients.
Methods and results In this multicentre, open-label, randomized controlled trial with blinded assessments, we compared losartan treatment with no additional treatment in operated and unoperated adults with Marfan syndrome. The primary endpoint was aortic dilatation rate at any predefined aortic level after 3 years of follow-up, as determined by magnetic resonance imaging. A total of 233 participants (47% female) underwent randomization to either losartan ( n = 116) or no additional treatment ( n = 117). Aortic root dilatation rate after 3.1 ± 0.4 years of follow-up was significantly lower in the losartan group than in controls (0.77 ± 1.36 vs. 1.35 ± 1.55 mm, P = 0.014). Aortic dilatation rate in the trajectory beyond the aortic root was not significantly reduced by losartan. In patients with prior aortic root replacement, aortic arch dilatation rate was significantly lower in the losartan group when compared with the control group (0.50 ± 1.26 vs. 1.01 ± 1.31 mm, P = 0.033). No significant differences in separate clinical endpoints or the composite endpoint (aortic dissection, elective aortic surgery, cardiovascular death) between the groups could be demonstrated.
Conclusion In adult Marfan patients, losartan treatment reduces aortic root dilatation rate. After aortic root replacement, losartan treatment reduces dilatation rate of the aortic arch.read more
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2018 ESC/ESH Guidelines for the management of arterial hypertension.
B. Williams,G. Mancia,Wilko Spiering,Agabiti Rosei E,M. Azizi,Michel Burnier,Denis Clement,A. Coca,de Simone G,A Dominiczak,T. Kahan,Felix Mahfoud,Josep Redon,L.M. Ruilope,Alberto Zanchetti,Mary Kerins,S.E. Kjeldsen,Reinhold Kreutz,S. Laurent,Lip Gyh.,Richard J McManus,Krzysztof Narkiewicz,Frank Ruschitzka,R.E. Schmieder,Evgeny Shlyakhto,Constantinos Tsioufis,Aboyans,Ileana Desormais +27 more
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2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC).
Raimund Erbel,Aboyans,Catherine Boileau,Eduardo Bossone,Roberto Di Bartolomeo,Holger Eggebrecht,Artur Evangelista,Falk,Herbert Frank,Oliver Gaemperli,Martin Grabenwöger,Haverich A,Bernard Iung,Athanasios J. Manolis,Folkert J. Meijboom,Christoph A. Nienaber,Marco Roffi,Hervé Rousseau,Sechtem U,Per Anton Sirnes,Allmen Rs,Christiaan J. Vrints +21 more
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2018 ESC/ESH Guidelines for the management of arterial hypertension : The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension
Bryan Williams,Giuseppe Mancia,Wilko Spiering,Enrico Agabiti Rosei,Michel Azizi,Michel Burnier,Denis Clement,Antonio Coca,Giovanni de Simone,Anna F. Dominiczak,Thomas Kahan,Felix Mahfoud,Josep Redon,Luis M. Ruilope,Alberto Zanchetti,Mary Kerins,Sverre E. Kjeldsen,Reinhold Kreutz,Stéphane Laurent,Gregory Y.H. Lip,Richard J McManus,Krzysztof Narkiewicz,Frank Ruschitzka,Roland E. Schmieder,Evgeny Shlyakhto,Costas Tsioufis,Victor Aboyans,Ileana Desormais +27 more
TL;DR: De Backer et al. as mentioned in this paper developed the ESC Guidelines for the ESC Review Co-ordinator, which are used for the evaluation of the ESC review process and the review process.
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Journal ArticleDOI
[2018 ESC/ESH Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH)].
Bryan Williams,Giuseppe Mancia,Wilko Spiering,Enrico Agabiti Rosei,Michel Azizi,Michel Burnier,Denis Clement,Antonio Coca,Giovanni de Simone,Anna F. Dominiczak,Thomas Kahan,Felix Mahfoud,Josep Redon,Luis M. Ruilope,Alberto Zanchetti,Mary Kerins,Sverre E. Kjeldsen,Reinhold Kreutz,Stéphane Laurent,Gregory Y.H. Lip,Richard J McManus,Krzysztof Narkiewicz,Frank Ruschitzka,Roland E. Schmieder,Evgeny Shlyakhto,Costas Tsioufis,Victor Aboyans,Ileana Desormais +27 more
TL;DR: Authors/Task Force Members: Bryan Williams* (ESC Chairperson), Giuseppe Mancia* (ESH Chairperson) (Italy), Wilko Spiering (The Netherlands), Enrico Agabiti Rosei ( Italy), Michel Azizi (France), Michel Burnier (Switzerland), Denis L. Kjeldsen (Norway), Reinhold Kreutz (Germany), Stephane Laurent (France)
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Journal ArticleDOI
Losartan, an AT1 antagonist, prevents aortic aneurysm in a mouse model of Marfan syndrome.
Jennifer P Habashi,Daniel P. Judge,Tammy M. Holm,Ronald D. Cohn,Bart Loeys,Timothy K. Cooper,Loretha Myers,Erin C Klein,Guosheng Liu,Carla L. Calvi,Megan Podowski,Enid Neptune,Marc K. Halushka,Djahida Bedja,Kathleen L. Gabrielson,Daniel B. Rifkin,Luca Carta,Francesco Ramirez,David L. Huso,Harry C. Dietz +19 more
TL;DR: Losartan, a drug already in clinical use for hypertension, merits investigation as a therapeutic strategy for patients with Marfan syndrome and has the potential to prevent the major life-threatening manifestation of this disorder.
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