title: Usefulness of enalapril versus propranolol or atenolol for prevention of aortic dilation in patients with the Marfan syndrome.
abstract: Despite variable clinical results, beta blockers have become the primary therapy for prevention of aortic dilation in patients with the Marfan syndrome. This study examines the use of the angiotensin-converting enzyme inhibitor enalapril for treatment of these patients. We sought to examine the effects of enalapril versus beta-blocker therapy in patients with the Marfan syndrome and noted improved aortic distensibility (3.0 +/- 0.3 vs 1.9 +/- 0.4 cm2 dynes(-1); p <0.02) and a reduced aortic stiffness index (8.0 +/- 2.9 vs 18.4 +/- 3.8; p <0.05) in patients receiving enalapril compared with those receiving beta blockers. These favorable hemodynamic changes were associated with a smaller increase in aortic root diameter (0.1 +/- 1.0 vs 5.8 +/- 5.2 mm) and fewer clinical end points during follow-up.
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Children's Hospital, University of Colorado Health Sciences Center, Denver, Colorado 80220, USA. Yetman.Angela@tchden.org
authors.forename: Anji T
authors.initials: AT
authors.lastname: Yetman
authors.forename: Renee A
authors.initials: RA
authors.lastname: Bornemeier
authors.forename: Brian W
authors.initials: BW
authors.lastname: McCrindle
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001011:Aorta / Q000002:abnormalities / Q000187:drug effects*; D001262:Atenolol / Q000627:therapeutic use*; D002648:Child; D004108:Dilatation, Pathologic / Q000188:drug therapy; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000188:drug therapy*; D011433:Propranolol / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001262:Atenolol; D004656:Enalapril; D011433:Propranolol