Cardiology Medical News about Marfan's syndrome and bicuspid aortic valve;role of beta-blockers

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Role of beta-blockers in Marfan's syndrome and bicuspid aortic valve: A time for re-appraisal
The Annals of Pediatric Cardiology, 11/13/08

Vaidyanathan B et al. – Use of beta-blockers in Marfan's syndrome pts may delay progression of aortic root dilatation and is a reasonable practice, despite conflicting reports on the efficacy of these agents in this population.

Methods

A meta-analysis and e-mail survey of expert opinion to clarify medical management with beta-blockers for pts with Marfan's syndrome and bicuspid aortic valve
Review of effects on slowing aortic root dilatation and cardiovascular effects - death, aortic dissection, and surgery
Investigation of when to initiate therapy in Marfan's syndrome pts

Results

Recommendation of beta-blockers is a reasonable practice in Marfan's syndrome pts with aortic root dilatation; however, some recent evidence suggests this therapy may not be beneficial
Beta-blockers may delay progression of aortic root dilatation, although these agent may not significantly affect harder clinical endpoints such as mortality and vascular complications
Further evaluation is needed to define the role of newer drugs such as losartan in Marfan's syndrome
In pts with bicuspid aortic valve, no current evidence supports use of any of these drugs