Abdominal aortic aneurysm expansion rate: effect of size and beta-adrenergic blockade.
OBJECTIVE
The purpose of this study was to investigate the hypothesis that abdominal aortic aneurysm (AAA) expansion may be slowed by beta-adrenergic antagonists.


METHODS
One hundred twenty-one patients with infrarenal AAA were monitored with serial aortic ultrasound examinations. Eighty-three patients received no beta-blockers (group I), and 38 patients received beta-blockers (group II). Values are expressed as mean +/- SD.


RESULTS
The mean follow-up was 43 +/- 29 months with 5.5 +/- 3.4 ultrasound examinations per patient. The expansion rate among all AAA was 0.38 +/- 0.44 cm/yr. Large aneurysms (> or = 5 cm) expanded significantly faster than small aneurysms (p = 0.02) in patients not treated with beta-blockers. Among patients with large AAA, those receiving beta-blockers had a significantly reduced mean expansion rate; 0.36 +/- 0.20 versus 0.68 +/- 0.64 cm/yr, (p < 0.05). Although rupture rates were lower in group I (5%) versus group II (13%), this difference was not statistically significant. Thirty-four patients in a poor-risk category with AAA were monitored greater than 5 cm in diameter. Ten of these AAA ruptured. The mean expansion rate was significantly greater in those patients with ruptured AAA versus those patients with AAA that did not rupture; 0.82 +/- 0.74 versus 0.42 +/- 0.41 cm/yr (p = 0.04).


CONCLUSIONS
In patients not undergoing beta-blocker therapy, large AAA expand at a significantly greater rate than smaller AAA. Large aneurysms that rupture show more rapid expansion than those AAA that do not rupture. We have demonstrated a significantly reduced rate of expansion of large AAA in patients receiving beta-blockade.
Gadowski
G R
GR
Department of Surgery, University of Vermont College of Medicine, Burlington.
Pilcher
D B
DB
Ricci
M A
MA
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology; D001019:Aortic Rupture / Q000453:epidemiology; D003327:Coronary Disease / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography
D000319:Adrenergic beta-Antagonists