{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T21:11:19Z","timestamp":1783717879514,"version":"3.55.0"},"reference-count":54,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[2008,4]]},"abstract":"<jats:p>It is accepted practice to prescribe \u03b2-blockers in order to retard aortic dilatation and prevent aortic dissection and rupture in patients with Marfan syndrome. A critical review of the published pharmacological studies shows this practice to be based on limited evidence. The data from small clinical and experimental studies with surrogate end points suggest greater potential benefit from alternative drug regimens, and a recent experimental study showed that losartan may interrupt the mechanism of disease as well as deal with its functional consequences. It is now essential to perform large, collaborative, randomised controlled trials with clinical end points of new treatments in Marfan syndrome.<\/jats:p>","DOI":"10.1136\/hrt.2006.109454","type":"journal-article","created":{"date-parts":[[2008,3,17]],"date-time":"2008-03-17T19:32:53Z","timestamp":1205782373000},"page":"414-421","source":"Crossref","is-referenced-by-count":47,"title":["Medical treatment of Marfan syndrome: a time for change"],"prefix":"10.1136","volume":"94","author":[{"given":"A","family":"Williams","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Davies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A G","family":"Stuart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D G","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A G","family":"Fraser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2008,3,17]]},"reference":[{"key":"2025092014392226000_94.4.414.1","first-page":"220","article-title":"Un cas de deformation congenitale des quatre members, plus prononcee aux extremities, caracterisee par l\u2019allongemont des os avec un certain degree d\u2019amincissement.","volume":"13","author":"Marfan","year":"1896","journal-title":"Bull Mem Soc Med Hop Paris"},{"key":"2025092014392226000_94.4.414.2","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1093\/hmg\/4.suppl_1.1799","article-title":"Mutations in human gene for fibrillin-1 in the Marfan syndrome and related disorders.","volume":"4","author":"Dietz","year":"1995","journal-title":"Hum Mol Genet"},{"key":"2025092014392226000_94.4.414.3","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1111\/j.1399-0004.1998.tb03714.x","article-title":"Life expectancy in British Marfan syndrome populations.","volume":"54","author":"Gray","year":"1998","journal-title":"Clin Genet"},{"key":"2025092014392226000_94.4.414.4","unstructured":"Government Actuaries Department. http:\/\/www.gad.gov.uk\/ (accessed 17 February 2008)"},{"key":"2025092014392226000_94.4.414.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)80066-1"},{"key":"2025092014392226000_94.4.414.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.04.049"},{"key":"2025092014392226000_94.4.414.7","unstructured":"UMD website. http:\/\/www.umd.be (accessed 11 February 2008)."},{"key":"2025092014392226000_94.4.414.8","doi-asserted-by":"publisher","DOI":"10.1038\/ng1392"},{"key":"2025092014392226000_94.4.414.9","doi-asserted-by":"crossref","first-page":"987","DOI":"10.2106\/00004623-197153050-00013","article-title":"Congenital contractural arachnodactyly. A heritable disorder of connective tissue.","volume":"53","author":"Beals","year":"1971","journal-title":"J Bone Joint Surg Am"},{"key":"2025092014392226000_94.4.414.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(10)80218-9"},{"key":"2025092014392226000_94.4.414.11","doi-asserted-by":"publisher","DOI":"10.3109\/10623329309102697"},{"key":"2025092014392226000_94.4.414.12","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.7.909"},{"key":"2025092014392226000_94.4.414.13","doi-asserted-by":"publisher","DOI":"10.1038\/ng1116"},{"key":"2025092014392226000_94.4.414.14","doi-asserted-by":"publisher","DOI":"10.1172\/JCI200422715"},{"key":"2025092014392226000_94.4.414.15","doi-asserted-by":"publisher","DOI":"10.1126\/science.1124287"},{"key":"2025092014392226000_94.4.414.16","unstructured":"Ringer RK . Influence of reserpine on early growth, blood pressure and dissecting aneurysms in turkeys. CIBA Summit, NJ 1959:21\u201328."},{"key":"2025092014392226000_94.4.414.17","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/S0022-5223(19)33192-7","article-title":"Treatment of dissecting aneurysms of the aorta without surgery.","volume":"50","author":"Wheat","year":"1965","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025092014392226000_94.4.414.18","first-page":"123","article-title":"A prospectus on the prevention of aortic rupture in the Marfan syndrome with data on survivorship without treatment.","volume":"129","author":"Halpern","year":"1971","journal-title":"Johns Hopkins Med J"},{"key":"2025092014392226000_94.4.414.19","first-page":"163","article-title":"Prophylactic use of propranolol in the Marfan syndrome to prevent aortic dissection.","volume":"13","author":"Ose","year":"1977","journal-title":"Birth Defects Orig Artic Ser"},{"key":"2025092014392226000_94.4.414.20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199405123301902"},{"key":"2025092014392226000_94.4.414.21","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1161\/01.CIR.91.4.1052","article-title":"Aortic and other vascular disease: differential effects of chronic oral antihypertensive therapies on systemic arterial circulation and ventricular energetics in African-American patients.","volume":"91","author":"Cholley","year":"1995","journal-title":"Circulation"},{"key":"2025092014392226000_94.4.414.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.07.039"},{"key":"2025092014392226000_94.4.414.23","doi-asserted-by":"publisher","DOI":"10.1097\/01.hjh.0000160211.56103.48"},{"key":"2025092014392226000_94.4.414.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjhyper.2005.08.007"},{"key":"2025092014392226000_94.4.414.25","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(94)90762-5"},{"key":"2025092014392226000_94.4.414.26","first-page":"H794","article-title":"Influence of sympathetic tone on mechanical properties of muscular arteries in humans.","volume":"268","author":"Joannides","year":"1995","journal-title":"Am J Physiol"},{"key":"2025092014392226000_94.4.414.27","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(97)70248-5"},{"key":"2025092014392226000_94.4.414.28","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(98)00315-4"},{"key":"2025092014392226000_94.4.414.29","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(93)90522-E"},{"key":"2025092014392226000_94.4.414.30","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1161\/01.CIR.79.4.854","article-title":"Arterial haemodynamic indexes in Marfan\u2019s syndrome.","volume":"79","author":"Yin","year":"1989","journal-title":"Circulation"},{"key":"2025092014392226000_94.4.414.31","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(99)70362-5"},{"key":"2025092014392226000_94.4.414.32","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(92)91207-K"},{"key":"2025092014392226000_94.4.414.33","doi-asserted-by":"publisher","DOI":"10.2165\/00148581-200507010-00003"},{"key":"2025092014392226000_94.4.414.34","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(99)00101-0"},{"key":"2025092014392226000_94.4.414.35","doi-asserted-by":"crossref","unstructured":"Yetman AT Bornemeier RA McCrindle BW . A comparison of beta-blockers and angiotensin converting enzyme inhibitors on aortic elastic properties, aortic growth, and left ventricular size and function in Marfan patients. J Am Coll Cardiol 2003;(Suppl):492A.","DOI":"10.1016\/S0735-1097(03)82683-9"},{"key":"2025092014392226000_94.4.414.36","first-page":"795","article-title":"Effects of perindopril on elastic and structural properties of large arteries in essential hypertension.","volume":"20","author":"Lacourciere","year":"2004","journal-title":"Can J Cardiol"},{"key":"2025092014392226000_94.4.414.37","doi-asserted-by":"crossref","first-page":"I-282","DOI":"10.1161\/hc37t1.094856","article-title":"Angiotensin 2 type receptor mediated vascular smooth muscle cell apoptosis in cystic medial degeneration associated with Marfan\u2019s syndrome.","volume":"104","author":"Nagashima","year":"2001","journal-title":"Circulation"},{"key":"2025092014392226000_94.4.414.38","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/S0741-5214(02)00139-8","article-title":"An angiotensin-converting enzyme inhibitor, not an angiotensin 2 type 1 receptor blocker, prevents \u03b2-aminopropionitrile monofumarate-induced aortic dissection in rats.","volume":"36","author":"Nagashima","year":"2002","journal-title":"J Vasc Surg"},{"key":"2025092014392226000_94.4.414.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.01.032"},{"key":"2025092014392226000_94.4.414.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.03.065"},{"key":"2025092014392226000_94.4.414.41","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.8.7.553"},{"key":"2025092014392226000_94.4.414.42","doi-asserted-by":"publisher","DOI":"10.1097\/01.hjh.0000182521.44440.c5"},{"key":"2025092014392226000_94.4.414.43","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.6.789"},{"key":"2025092014392226000_94.4.414.44","unstructured":"National Marfan foundation. . http:\/\/www.marfan.org\/nmf (accessed 11 February 2008)."},{"key":"2025092014392226000_94.4.414.45","unstructured":"Current controlled trials. The effects of angiotensin 2 blockade and long acting nitrates on arterial stiffness in patients with Marfan syndrome. A placebo controlled study (NITRATES)). (ISRCTN28168217) Available at http:\/\/www.controlled-trials.com (accessed 11 February 2008)."},{"key":"2025092014392226000_94.4.414.46","doi-asserted-by":"crossref","first-page":"381","DOI":"10.2310\/6650.2001.33783","article-title":"Matrix metalloproteinases: from biology to therapeutic strategies in cardiovascular disease.","volume":"49","author":"Benjamin","year":"2001","journal-title":"J Invest Med"},{"key":"2025092014392226000_94.4.414.47","first-page":"II331","article-title":"Immunohistochemistry of matrix metalloproteinases and their inhibitors in thoracic aortic aneurysms and aortic valves of patients with Marfan\u2019s syndrome.","volume":"98","author":"Segura","year":"1998","journal-title":"Circulation"},{"key":"2025092014392226000_94.4.414.48","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1999.tb07682.x"},{"key":"2025092014392226000_94.4.414.49","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(00)90163-0"},{"key":"2025092014392226000_94.4.414.50","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200464050-00001"},{"key":"2025092014392226000_94.4.414.51","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.98.3.1171"},{"key":"2025092014392226000_94.4.414.52","doi-asserted-by":"publisher","DOI":"10.1161\/hc3801.097806"},{"key":"2025092014392226000_94.4.414.53","doi-asserted-by":"publisher","DOI":"10.1016\/j.ehj.2003.08.020"},{"key":"2025092014392226000_94.4.414.54","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19960424)62:4<417::AID-AJMG15>3.0.CO;2-R"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/hrt.2006.109454","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T21:39:31Z","timestamp":1758404371000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/hrt.2006.109454"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,3,17]]},"references-count":54,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2008,3,17]]},"published-print":{"date-parts":[[2008,4]]}},"alternative-id":["10.1136\/hrt.2006.109454"],"URL":"https:\/\/doi.org\/10.1136\/hrt.2006.109454","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"value":"1355-6037","type":"print"},{"value":"1468-201X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,3,17]]}}}