PT  - JOURNAL ARTICLE
AU  - C D M van Karnebeek
AU  - M S J Naeff
AU  - B J M Mulder
AU  - R C M Hennekam
AU  - M Offringa
TI  - Natural history of cardiovascular manifestations in Marfan syndrome
AID  - 10.1136/adc.84.2.129
DP  - 2001 Feb 01
TA  - Archives of Disease in Childhood
PG  - 129--137
VI  - 84
IP  - 2
4099  - http://adc.bmj.com/content/84/2/129.short
4100  - http://adc.bmj.com/content/84/2/129.full
SO  - Arch Dis Child2001 Feb 01; 84
AB  - AIMS To investigate the natural history of mitral valve and aortic abnormalities in patients with Marfan syndrome during childhood and adolescence.METHODS Fifty two patients with Marfan syndrome were followed for a mean of 7.9 years. Occurrence of adverse cardiovascular outcomes was measured clinically and by ultrasound examination.RESULTS Mitral valve prolapse (MVP) was diagnosed in 46 patients at a mean age of 9.7 years, more than 80% of whom presented as “silent MVP”. Mitral regurgitation (MR) occurred in 25 patients, aortic dilatation in 43, and aortic regurgitation (AR) in 13. Both MVP and aortic dilatation developed at a constant rate during the age period 5–20 years. In 23 patients MVP was diagnosed before aortic dilatation, in 18 the reverse occurred, and in 11 patients the two abnormalities were diagnosed simultaneously. During follow up, 21 patients showed progression of mitral valve dysfunction; progression of aortic abnormalities occurred in 13. Aortic surgery was performed in 10; two died of subsequent complications. Mitral valve surgery was performed in six. In sporadic female Marfan patients the age at initial diagnosis of MVP, MR, aortic dilatation, and AR was lowest, the grade of MR and AR most severe, the time lapse between the occurrence of MVP and subsequent MR as well as between dilatation and subsequent AR shortest, and the risk for cardiovascular associated morbidity and mortality highest.CONCLUSIONS During childhood and adolescence in Marfan syndrome, mitral valve dysfunction as well as aortic abnormalities develop and progress gradually, often without symptoms, but may cause considerable morbidity and mortality by the end of the second decade, especially in female sporadic patients.