Thoracic Aorta Pravastatin Reduces Marfan Aortic Dilation McLoughlin D, McGuinness J, Byrne J, et al (Royal College of Surgeons in Ireland, Dublin; et al) Circulation 124:S168-S173, 2011§ G.L. Moneta, MD Evidence Ranking • C Expert Rating • 1 Abstract Background The sequelae of aortic root dilation are the lethal consequences of Marfan syndrome. The root dilation is attributable to an imbalance between deposition of matrix elements and metalloproteinases in the aortic medial layer as a result of excessive transforming growth factor-beta signaling. This study examined the efficacy and mechanism of statins in attenuating aortic root dilation in Marfan syndrome and compared effects to the other main proposed preventative agent, losartan. Methods and Results Marfan mice heterozygous for a mutant allele encoding a cysteine substitution in fibrillin-1 (C1039G) were treated daily from 6 weeks old with pravastatin 0.5 g/L or losartan 0.6 g/L. The end points of aortic root diameter (n=25), aortic thickness, and architecture (n=10), elastin volume (n=5), dp/dtmax (maximal rate of change of pressure) (cardiac catheter; n=20), and ultrastructural analysis with stereology (electron microscopy; n=5) were examined. The aortic root diameters of untreated Marfan mice were significantly increased in comparison to normal mice (0.161±0.001 cm vs 0.252±0.004 cm; P<0.01). Pravastatin (0.22±0.003 cm; P<0.01) and losartan (0.221±0.004 cm; P<0.01) produced a significant reduction in aortic root dilation. Both drugs also preserved elastin volume within the medial layer (pravastatin 0.23±0.02 and losartan 0.29±0.03 vs untreated Marfan 0.19±0.02; P=0.01; normal mice 0.27±0.02). Ultrastructural analysis showed a reduction of rough endoplasmic reticulum in smooth muscle cells with pravastatin (0.022±0.004) and losartan (0.013±0.001) compared to untreated Marfan mice (0.035±0.004; P<0.01). Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Function Testing of Platelets and Long-term Outcome of Patients with Peripheral Arterial Disease Undergoing Transluminal Angioplasty Hemorrhage Is Much More Common After Carotid Stenting Than After Endarterectomy: Evidence From the National Inpatient Sample oral antiplatelet therapy may increase the risk of hemorrhagic complications in patients with acute ischemic stroke caused by large artery disease and Removal of Inferior Vena Cava Filters: National Trends in the Medicare Population Stay updated, free articles. Join our Telegram channel Join Tags: Year Book of Vascular Surgery 2012 Apr 1, 2017 | Posted by admin in CARDIOLOGY | Comments Off on Reduces Marfan Aortic Dilation Full access? Get Clinical Tree
Thoracic Aorta Pravastatin Reduces Marfan Aortic Dilation McLoughlin D, McGuinness J, Byrne J, et al (Royal College of Surgeons in Ireland, Dublin; et al) Circulation 124:S168-S173, 2011§ G.L. Moneta, MD Evidence Ranking • C Expert Rating • 1 Abstract Background The sequelae of aortic root dilation are the lethal consequences of Marfan syndrome. The root dilation is attributable to an imbalance between deposition of matrix elements and metalloproteinases in the aortic medial layer as a result of excessive transforming growth factor-beta signaling. This study examined the efficacy and mechanism of statins in attenuating aortic root dilation in Marfan syndrome and compared effects to the other main proposed preventative agent, losartan. Methods and Results Marfan mice heterozygous for a mutant allele encoding a cysteine substitution in fibrillin-1 (C1039G) were treated daily from 6 weeks old with pravastatin 0.5 g/L or losartan 0.6 g/L. The end points of aortic root diameter (n=25), aortic thickness, and architecture (n=10), elastin volume (n=5), dp/dtmax (maximal rate of change of pressure) (cardiac catheter; n=20), and ultrastructural analysis with stereology (electron microscopy; n=5) were examined. The aortic root diameters of untreated Marfan mice were significantly increased in comparison to normal mice (0.161±0.001 cm vs 0.252±0.004 cm; P<0.01). Pravastatin (0.22±0.003 cm; P<0.01) and losartan (0.221±0.004 cm; P<0.01) produced a significant reduction in aortic root dilation. Both drugs also preserved elastin volume within the medial layer (pravastatin 0.23±0.02 and losartan 0.29±0.03 vs untreated Marfan 0.19±0.02; P=0.01; normal mice 0.27±0.02). Ultrastructural analysis showed a reduction of rough endoplasmic reticulum in smooth muscle cells with pravastatin (0.022±0.004) and losartan (0.013±0.001) compared to untreated Marfan mice (0.035±0.004; P<0.01). Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Function Testing of Platelets and Long-term Outcome of Patients with Peripheral Arterial Disease Undergoing Transluminal Angioplasty Hemorrhage Is Much More Common After Carotid Stenting Than After Endarterectomy: Evidence From the National Inpatient Sample oral antiplatelet therapy may increase the risk of hemorrhagic complications in patients with acute ischemic stroke caused by large artery disease and Removal of Inferior Vena Cava Filters: National Trends in the Medicare Population Stay updated, free articles. Join our Telegram channel Join Tags: Year Book of Vascular Surgery 2012 Apr 1, 2017 | Posted by admin in CARDIOLOGY | Comments Off on Reduces Marfan Aortic Dilation Full access? Get Clinical Tree
