TY - JOUR
T1 - Circulating transforming growth factor-β as a prognostic biomarker in Marfan syndrome
AU - Franken, Romy
AU - den Hartog, Alexander W.
AU - de Waard, Vivian
AU - Engele, Leo
AU - Radonic, Teodora
AU - Lutter, Rene
AU - Timmermans, Janneke
AU - Scholte, Arthur J.
AU - van den Berg, Maarten P.
AU - Zwinderman, Aeilko H.
AU - Groenink, Maarten
AU - Mulder, Barbara J. M.
PY - 2013
Y1 - 2013
N2 - Patients with Marfan syndrome (MFS) are at risk for cardiovascular disease. Marfan associated mutations in the FBN1 gene lead to increased transforming growth factor-β (TGF-β) activation. The aim of this study was to investigate the role of plasma TGF-β as a biomarker for progressive aortic root dilatation and dissection. Plasma TGF-β level and aortic root diameter by means of echocardiography were assessed in 99 MFS patients. After 38 months of follow-up measurement of the aortic root was repeated and individual aortic root growth curves were constructed. Clinical events were evaluated. The primary composite endpoint was defined as aortic dissection and prophylactic aortic root replacement. TGF-β levels were higher in MFS patients as compared to healthy controls (109 pg/ml versus 54 pg/ml, p <0.001). Higher plasma TGF-β levels correlated with larger aortic root dimensions (r=0.26, p=0.027), previous aortic root surgery (161 pg/ml versus 88 pg/ml, p=0.007) and faster aortic root growth rate (r=0.42, p <0.001). During 38 months of follow-up, 17 events were observed (four type B dissections and 13 aortic root replacements). Patients with TGF-β levels above 140 pg/ml had a 6.5 times higher risk of experiencing the composite endpoint compared to patients with TGF-β levels below 140 pg/ml (95% CI: 2.1 to 20.1, p=0.001) with 65% sensitivity and 78% specificity. Elevated TGF-β level in patients with Marfan syndrome is correlated with larger aortic root diameters and faster aortic root growth. Level of plasma TGF-β predicts cardiovascular events and might serve as a prognostic biomarker in MFS
AB - Patients with Marfan syndrome (MFS) are at risk for cardiovascular disease. Marfan associated mutations in the FBN1 gene lead to increased transforming growth factor-β (TGF-β) activation. The aim of this study was to investigate the role of plasma TGF-β as a biomarker for progressive aortic root dilatation and dissection. Plasma TGF-β level and aortic root diameter by means of echocardiography were assessed in 99 MFS patients. After 38 months of follow-up measurement of the aortic root was repeated and individual aortic root growth curves were constructed. Clinical events were evaluated. The primary composite endpoint was defined as aortic dissection and prophylactic aortic root replacement. TGF-β levels were higher in MFS patients as compared to healthy controls (109 pg/ml versus 54 pg/ml, p <0.001). Higher plasma TGF-β levels correlated with larger aortic root dimensions (r=0.26, p=0.027), previous aortic root surgery (161 pg/ml versus 88 pg/ml, p=0.007) and faster aortic root growth rate (r=0.42, p <0.001). During 38 months of follow-up, 17 events were observed (four type B dissections and 13 aortic root replacements). Patients with TGF-β levels above 140 pg/ml had a 6.5 times higher risk of experiencing the composite endpoint compared to patients with TGF-β levels below 140 pg/ml (95% CI: 2.1 to 20.1, p=0.001) with 65% sensitivity and 78% specificity. Elevated TGF-β level in patients with Marfan syndrome is correlated with larger aortic root diameters and faster aortic root growth. Level of plasma TGF-β predicts cardiovascular events and might serve as a prognostic biomarker in MFS
U2 - https://doi.org/10.1016/j.ijcard.2013.03.033
DO - https://doi.org/10.1016/j.ijcard.2013.03.033
M3 - Article
C2 - 23582687
SN - 0167-5273
VL - 168
SP - 2441
EP - 2446
JO - International journal of cardiology
JF - International journal of cardiology
IS - 3
ER -