Role of beta-blockers in Marfan's syndrome and bicuspid aortic valve: A time for re-appraisal
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
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