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Aortic root growth in men and women with the Marfan's syndrome

Lilian J Meijboom1, Janneke Timmermans, Aeiko H Zwinderman

  • 1Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands.

The American Journal of Cardiology
|November 9, 2005
PubMed

Insights

Men and women with Marfan syndrome (MS) show different aortic root growth rates. Fast-growing aortic roots in MS patients are linked to increased dissection risk, suggesting gender-specific screening and treatment thresholds.

Area of Science:

  • Cardiology
  • Genetics
  • Vascular Surgery

Background:

  • Marfan syndrome (MS) is a genetic disorder affecting connective tissue.
  • Aortic root dilation and subsequent type A aortic dissection or rupture are leading causes of premature death in MS patients.
  • Current guidelines for aortic root replacement do not fully account for gender-specific differences in aortic growth.

Purpose of the Study:

  • To analyze and compare aortic root growth patterns in men and women with Marfan syndrome.
  • To identify subgroups of fast and slow aortic root growers within the MS population.
  • To evaluate the association between aortic root growth rates and the incidence of type A aortic dissection.

Main Methods:

  • Prospective follow-up of 113 men and 108 women with Marfan syndrome.
  • Serial echocardiograms to measure native aortic root diameter.
  • Statistical analysis to determine average growth rates and identify fast/slow growers based on gender.

Main Results:

  • Women had a smaller baseline aortic root diameter (adjusted for age) compared to men.
  • Average aortic root growth was 0.42 mm/year in men and 0.38 mm/year in women.
  • Fast-growing aortic roots (approx. 1 in 7 men, 1 in 9 women) were associated with a significantly higher incidence of type A dissections (25% vs 4% in slow growers).

Conclusions:

  • Gender differences in aortic root growth exist in Marfan syndrome.
  • Aortic root growth rate is a significant predictor of type A dissection risk.
  • The study proposes reducing the threshold for elective aortic root replacement in women with MS by 5 mm to prevent dissections.

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