Beta-blocker therapy does not alter the rate of aortic root dilation in pediatric patients with Marfan syndrome.
OBJECTIVE
To test the hypothesis that chronic beta-blocker therapy in pediatric patients with Marfan syndrome alters the rate of aortic root dilation. Beta-blockade has been advocated as preventive therapy for Marfan syndrome based on reports indicating a decreased rate of aortic root dilation in treated patients.


METHODS
Patients with Marfan syndrome (n = 63) followed at Children's Hospital of Pittsburgh or Children's Hospital of New York-Presbyterian who had > or =18 months of echocardiographic follow-up were studied. All clinical data and 213 serial echocardiograms were reviewed, and aortic root dimensions were measured. Patients were divided into 2 groups for comparison: untreated (n = 34) and treated (n = 29).


RESULTS
At study entry, the 2 study groups were comparable in terms of age, sex, body surface area (BSA), aortic root measurements, heart rate, and corresponding z scores. Follow-up duration in each group was similar. At last follow-up, heart rates and heart rate z scores were lower in the treated group. Rates of change of aortic root measurements (P = .52) and the corresponding z scores were not statistically different between the 2 group at the study's end.


CONCLUSIONS
This study suggests that that beta-blocker therapy does not significantly alter the rate of aortic root dilation in children with Marfan syndrome. Based on these data, the recommendation of lifetime beta-blocker therapy instituted during childhood should be reassessed.
Selamet Tierney
Elif Seda
ES
Division of Pediatric Cardiology, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University, College of Physicians & Surgeons, New York, NY, USA. Seda.Tierney@cardio.chboston.org
Feingold
Brian
B
Printz
Beth F
BF
Park
Sang C
SC
Graham
Dionne
D
Kleinman
Charles S
CS
Mahnke
C Becket
CB
Timchak
Donna M
DM
Neches
William H
WH
Gersony
Welton M
WM
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000187:drug effects; D001262:Atenolol / Q000627:therapeutic use; D002648:Child; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008382:Marfan Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000517:prevention & control*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D001262:Atenolol