{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:28:07Z","timestamp":1791300487794,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2012,4,3]],"date-time":"2012-04-03T00:00:00Z","timestamp":1333411200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:sec><jats:label\/><jats:p>Eur J Clin Invest 2012<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background\u2002<\/jats:bold> Aortic dilatation is the main therapeutic target in patients with Marfan syndrome. Standard treatment with a \u03b2\u2010blocker may not lower central pulse pressure \u2013 the major objective \u2013 because it does not do so in hypertension, unlike angiotensin\u2010converting enzyme inhibitors and calcium\u2010channel blockers. We therefore performed a prospective, randomised, double\u2010blind, crossover trial to compare the effects of these three agents on large artery function and central aortic pressure in patients with Marfan syndrome.<\/jats:p><jats:p><jats:bold>Methods and Results\u2002<\/jats:bold> Eighteen patients had applanation tonometry, pulse wave analysis and echocardiography, before and after atenolol 75\u2003mg, perindopril 4\u2003mg and verapamil 240\u2003mg, each given for 4\u2003weeks, in a random order, with 2\u2003weeks between medications. Fourteen patients completed the study. Within\u2010drug comparisons demonstrated that perindopril (\u221210\u00b73\u2003mmHg, <jats:italic>P<\/jats:italic>\u2003=\u20030\u00b7002), verapamil (\u22129\u00b72\u2003mmHg, <jats:italic>P<\/jats:italic>\u2003=\u20030\u00b7003) and atenolol (\u22127\u00b71\u2003mmHg, <jats:italic>P<\/jats:italic>\u2003=\u20030\u00b701) all reduced central systolic pressure and brachial pressure; central changes were least, and peripheral changes greatest with atenolol but between\u2010drug comparisons (analysis of covariance) were not significant. There was a trend for augmentation to be reduced by perindopril (\u22126\u00b73%, <jats:italic>P<\/jats:italic>\u2003=\u20030\u00b705), verapamil (\u22125\u00b75%, <jats:italic>P<\/jats:italic>\u2003=\u20030\u00b707) and atenolol (\u22123\u00b72%, <jats:italic>P<\/jats:italic>\u2003=\u20030\u00b709). Only atenolol reduced heart rate (by 16%) and delayed expansion in the arch and abdominal aorta (by 8% and 11%) (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b7001, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b701 and <jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b705, respectively, for between\u2010drug comparisons).<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Perindopril, verapamil and atenolol all reduced peripheral and central systolic pressure. As atenolol slowed heart rate and delayed aortic wave travel, \u03b2\u2010blockade may have a continuing role in the treatment of patients with Marfan syndrome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2362.2012.02668.x","type":"journal-article","created":{"date-parts":[[2012,2,28]],"date-time":"2012-02-28T18:16:45Z","timestamp":1330453005000},"page":"891-899","source":"Crossref","is-referenced-by-count":35,"title":["Effects of atenolol, perindopril and verapamil on haemodynamic and vascular function in Marfan syndrome \u2013 a randomised, double\u2010blind, crossover trial"],"prefix":"10.1111","volume":"42","author":[{"given":"Andrew","family":"Williams","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damien","family":"Kenny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Fagenello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martyn","family":"Nelson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Dunstan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Cockcroft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Stuart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan G.","family":"Fraser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,4,3]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199204023261401"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0004.1998.tb03714.x"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197204132861502"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)80066-1"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/ng1116"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199405123301902"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.595496"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.20.2677"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjhyper.2003.09.012"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.13.1539"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.01.032"},{"key":"e_1_2_9_13_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7326\/0003-4819-152-11-201006010-00232","article-title":"CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials","volume":"152","author":"Schulz KF","year":"2010","journal-title":"Ann Int Med"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.2009.02234.x"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(89)90430-X"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000058171.62847.90"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00344-6"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2003.12.067"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.95.7.1827"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/hy1001.096106"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.109454"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.91.4.1052"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.1124287"},{"key":"e_1_2_9_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc081528"},{"issue":"1","key":"e_1_2_9_25_2","doi-asserted-by":"crossref","first-page":"I282","DOI":"10.1161\/hc37t1.094856","article-title":"Angiotensin II type 2 receptor mediates vascular smooth muscle cell apoptosis in cystic medial degeneration associated with Marfan\u2019s syndrome","volume":"104","author":"Nagashima H","year":"2001","journal-title":"Circulation"},{"key":"e_1_2_9_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2007.06.024"},{"key":"e_1_2_9_27_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706585"},{"key":"e_1_2_9_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(99)00101-0"},{"key":"e_1_2_9_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(94)90762-5"},{"key":"e_1_2_9_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(97)70248-5"},{"key":"e_1_2_9_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(93)90522-E"},{"key":"e_1_2_9_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(99)70362-5"},{"key":"e_1_2_9_33_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.79.4.854"},{"key":"e_1_2_9_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.109.134379"},{"key":"e_1_2_9_35_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jhh.1000581"},{"key":"e_1_2_9_36_2","first-page":"501","article-title":"Effect of aortic stiffness on left ventricular long\u2010axis function in adults with Marfan Syndrome","volume":"51","author":"Kiotsekoglou A","year":"2010","journal-title":"Hellenic J Cardiol"},{"key":"e_1_2_9_37_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq165"},{"key":"e_1_2_9_38_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.109.133801"},{"key":"e_1_2_9_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2009.08.003"},{"key":"e_1_2_9_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2006.07.001"},{"key":"e_1_2_9_41_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.84.3.1049"},{"key":"e_1_2_9_42_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00380-003-0700-5"},{"key":"e_1_2_9_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2008.08.013"},{"key":"e_1_2_9_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2010.01.008"},{"key":"e_1_2_9_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90559-J"},{"key":"e_1_2_9_46_2","doi-asserted-by":"publisher","DOI":"10.1038\/ajh.2008.156"},{"key":"e_1_2_9_47_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.110.155507"},{"key":"e_1_2_9_48_2","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0b013e3283232a45"}],"container-title":["European Journal of Clinical Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-2362.2012.02668.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-2362.2012.02668.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T10:28:09Z","timestamp":1698748089000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-2362.2012.02668.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,4,3]]},"references-count":47,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2012,8]]}},"alternative-id":["10.1111\/j.1365-2362.2012.02668.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-2362.2012.02668.x","archive":["Portico"],"relation":{},"ISSN":["0014-2972","1365-2362"],"issn-type":[{"value":"0014-2972","type":"print"},{"value":"1365-2362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,4,3]]}}}