Impairment of flow-mediated dilation correlates with aortic dilation in patients with Marfan syndrome

Munenori Takata, Eisuke Amiya, Masafumi Watanabe, Kazuko Omori, Yasushi Imai, Daishi Fujita, Hiroshi Nishimura, Masayoshi Kato, Tetsuro Morota, Kan Nawata, Atsuko Ozeki, Aya Watanabe, Shuichi Kawarasaki, Yumiko Hosoya, Tomoko Nakao, Koji Maemura, Ryozo Nagai, Yasunobu Hirata, Issei Komuro

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15 Citations (Scopus)

Abstract

Marfan syndrome is an inherited disorder characterized by genetic abnormality of microfibrillar connective tissue proteins. Endothelial dysfunction is thought to cause aortic dilation in subjects with a bicuspid aortic valve; however, the role of endothelial dysfunction and endothelial damaging factors has not been elucidated in Marfan syndrome. Flow-mediated dilation, a noninvasive measurement of endothelial function, was evaluated in 39 patients with Marfan syndrome. Aortic diameter was measured at the aortic annulus, aortic root at the sinus of Valsalva, sinotubular junction and ascending aorta by echocardiography, and adjusted for body surface area (BSA). The mean value of flow-mediated dilation was 6.5 ± 2.4 %. Flow-mediated dilation had a negative correlation with the diameter of the ascending thoracic aorta (AscAd)/BSA (R = -0.39, p = 0.020) and multivariate analysis revealed that flow-mediated dilation was an independent factor predicting AscAd/BSA, whereas other segments of the aorta had no association. Furthermore, Brinkman index had a somewhat greater influence on flow-mediated dilation (R = -0.42, p = 0.008). Although subjects who smoked tended to have a larger AscAd compared with non-smokers (AscA/BSA: 17.3 ± 1.8 versus 15.2 ± 3.0 mm/m 2, p = 0.013), there was no significant change in flow-mediated dilation, suggesting that smoking might affect aortic dilation via an independent pathway. Common atherogenic risks, such as impairment of flow-mediated dilation and smoking status, affected aortic dilation in subjects with Marfan syndrome.

Original languageEnglish
Pages (from-to)478-485
Number of pages8
JournalHeart and Vessels
Volume29
Issue number4
DOIs
Publication statusPublished - 2014 Jul

Keywords

  • Aortic diameter
  • Flow-mediated dilation
  • Marfan syndrome
  • Smoking status

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Takata, M., Amiya, E., Watanabe, M., Omori, K., Imai, Y., Fujita, D., Nishimura, H., Kato, M., Morota, T., Nawata, K., Ozeki, A., Watanabe, A., Kawarasaki, S., Hosoya, Y., Nakao, T., Maemura, K., Nagai, R., Hirata, Y., & Komuro, I. (2014). Impairment of flow-mediated dilation correlates with aortic dilation in patients with Marfan syndrome. Heart and Vessels, 29(4), 478-485. https://doi.org/10.1007/s00380-013-0393-3