title: β-Blockers and angiotensin converting enzyme inhibitors: comparison of effects on aortic growth in pediatric patients with Marfan syndrome.
abstract: OBJECTIVE
  Angiotensin converting enzyme inhibitors (ACEI) have been shown to decrease aortic growth velocity (AGV) in Marfan syndrome (MFS). We sought to compare the effect of β-blockers and ACEI on AGV in MFS.
  
  
  METHODS
  We retrospectively reviewed all data from all patients with MFS seen at Arkansas Children's Hospital between January 1, 1976 and January 1, 2013. Generalized least squares were used to evaluate AGV over time as a function of age, medication group, and the interaction between the 2. A mixed model was used to compare AGV between medication groups as a function of age, medication group (none, β-blocker, ACEI), and the interaction between the 2.
  
  
  RESULTS
  A total of 67 patients with confirmed MFS were identified (34/67, 51% female). Mean age at first encounter was 13 ± 10 years, with mean follow-up of 7.6 ± 5.8 years. There were 839 patient encounters with a median of 10 (range 2-42) encounters per patient. AGV was nearly normal in the β-blocker group, and was less than either the ACEI or untreated groups. The AGV was higher than normal in ACEI and untreated groups (P < .001 for both).
  
  
  CONCLUSIONS
  β-blocker therapy results in near-normalization of AGV in MFS. ACEI did not decrease AGV in a clinically significant manner.
authors.affiliation: Arkansas Children's Hospital, Little Rock, AR; The University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Venusa
authors.initials: V
authors.lastname: Phomakay
authors.affiliation: Arkansas Children's Hospital, Little Rock, AR.
authors.forename: Wilson G
authors.initials: WG
authors.lastname: Huett
authors.affiliation: Arkansas Children's Hospital, Little Rock, AR; The University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Gossett
authors.affiliation: Arkansas Children's Hospital, Little Rock, AR; The University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Tang
authors.affiliation: Arkansas Children's Hospital, Little Rock, AR; The University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Renee A
authors.initials: RA
authors.lastname: Bornemeier
authors.affiliation: Arkansas Children's Hospital, Little Rock, AR; The University of Arkansas for Medical Sciences, Little Rock, AR. Electronic address: rtcollins@uams.edu.
authors.forename: R Thomas
authors.initials: RT
authors.lastname: Collins
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001011:Aorta / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology*; D001131:Arkansas; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors
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