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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2016.1
- 수록면
- 81 - 87 (7page)
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초록· 키워드
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Purpose: In this study, we evaluated the long term beneficial effect of Renin-Angiotensin-Aldosterone System (RAAS) blockadetherapy in treatment of Marfan aortopathy.
Materials and Methods: We reviewed Marfan syndrome (MFS) patients who underwent aortic root replacement (ARR) betweenJanuary 1996 and January 2011. All patients were prescribed β-blockers indefinitely. We compared major aortic events includingmortality, aortic dissection, and reoperation in patients without RAAS blockade (group 1, n=27) to those with (group 2, n=63). Theaortic growth rate was calculated by dividing the diameter change on CT scans taken immediately post-operatively and the latestscan available.
Results: There were no differences in clinical parameters except for age which was higher in patients with RAAS blockade. Ingroup 1, 2 (7%) deaths, 5 (19%) aortic dissections, and 7 (26%) reoperations occurred. In group 2, 3 (5%) deaths, 2 (3%) aortic dissections,and 3 (5%) reoperations occurred. A Kaplan-Meier plot demonstrated improved survival free from major aortic eventsin group 2. On multivariate Cox, RAAS blockade was an independent negative predictor of major aortic events (hazard ratio 0.38,95% confidence interval 0.30–0.43, p=0.002). Mean diameter change in descending thoracic and supra-renal abdominal aortawas significantly higher in patients without RAAS blockade (p<0.05).
Conclusion: In MFS patients who underwent ARR, the addition of RAAS blockade to β-blocker was associated with reduction ofaortic dilatation and clinical events.
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참고문헌 (26)
참고문헌 신청
Ades L / 2007 / Guidelines for the diagnosis and management of Marfan syndrome / Heart Lung Circ 16 : 28 ~ 30
Brooke BS / 2008 / Angiotensin II blockade and aortic-root dilation in Marfan’s syndrome / N Engl J Med 358 : 2787 ~ 2795
Canadas V / 2010 / Marfan syndrome. Part 1:pathophysiology and diagnosis / Nat Rev Cardiol 7 : 256 ~ 265
Finkbohner R / 1995 / Marfan syndrome. Long-term survival and complications after aortic aneurysm repair / Circulation 91 : 728 ~ 733
Geisbuesch S / 2012 / Frequency of reoperations in patients with Marfan syndrome / Ann Thorac Surg 93 : 1496 ~ 1501
Brooke BS / 2008 / Angiotensin II blockade and aortic-root dilation in Marfan’s syndrome / N Engl J Med 358 : 2787 ~ 2795
Canadas V / 2010 / Marfan syndrome. Part 1:pathophysiology and diagnosis / Nat Rev Cardiol 7 : 256 ~ 265
Finkbohner R / 1995 / Marfan syndrome. Long-term survival and complications after aortic aneurysm repair / Circulation 91 : 728 ~ 733
Geisbuesch S / 2012 / Frequency of reoperations in patients with Marfan syndrome / Ann Thorac Surg 93 : 1496 ~ 1501
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