A critical analysis of minor cardiovascular criteria in the diagnostic evaluation of patients with Marfan syndrome

Julie De Backer, Bart Loeys, Dan Devos, Harry C Dietz, Johan De Sutter, Anne De Paepe

Research output: Contribution to journalArticle

Abstract

PURPOSE: The prevalence of most minor cardiovascular manifestations in Marfan syndrome (MFS) is unknown. We assessed the prevalence of minor cardiovascular manifestations in MFS to evaluate their usefulness in a diagnostic setting. METHODS: Seventy-seven patients with MFS (aged 4 months to 55 years) underwent echocardiography to assess the presence of mitral valve prolapse and the diameter of the main pulmonary artery. A subset of 29 adult patients with MFS also underwent magnetic resonance imaging evaluation of the diameters of the thoracoabdominal aorta. RESULTS: Mitral valve prolapse was encountered in 66% of patients with MFS, with an equal distribution of classic and nonclassic mitral valve prolapse. The main pulmonary artery diameter was significantly larger in patients with MFS at all ages when compared with controls. In the adult group (≥14 years), we were able to provide a cutoff value of 23 mm to define pulmonary artery dilatation. The descending aorta was enlarged, but with substantial overlap with controls, thus precluding the use of a cutoff value. CONCLUSIONS: Mitral valve prolapse and main pulmonary artery dilatation are common findings in MFS patients at all ages and are easy to assess with echocardiography. Cutoff values to define dilatation of the descending aorta are hard to define, making them of limited value in the diagnostic evaluation. We recommend echocardiographic evaluation of mitral valve proplase and main pulmonary artery diameter in patients referred for cardiovascular diagnostic assessment for MFS.

Original languageEnglish (US)
Pages (from-to)401-408
Number of pages8
JournalGenetics in Medicine
Volume8
Issue number7
DOIs
StatePublished - Jul 2006

Fingerprint

Marfan Syndrome
Mitral Valve Prolapse
Pulmonary Artery
Dilatation
Thoracic Aorta
Echocardiography
Mitral Valve
Aorta
Magnetic Resonance Imaging

Keywords

  • Cardiovascular
  • Diagnostic criteria
  • Marfan syndrome

ASJC Scopus subject areas

  • Genetics(clinical)
  • Genetics

Cite this

A critical analysis of minor cardiovascular criteria in the diagnostic evaluation of patients with Marfan syndrome. / De Backer, Julie; Loeys, Bart; Devos, Dan; Dietz, Harry C; De Sutter, Johan; De Paepe, Anne.

In: Genetics in Medicine, Vol. 8, No. 7, 07.2006, p. 401-408.

Research output: Contribution to journalArticle

De Backer, Julie ; Loeys, Bart ; Devos, Dan ; Dietz, Harry C ; De Sutter, Johan ; De Paepe, Anne. / A critical analysis of minor cardiovascular criteria in the diagnostic evaluation of patients with Marfan syndrome. In: Genetics in Medicine. 2006 ; Vol. 8, No. 7. pp. 401-408.
@article{643be690d8054a24af2924f8bd0d759e,
title = "A critical analysis of minor cardiovascular criteria in the diagnostic evaluation of patients with Marfan syndrome",
abstract = "PURPOSE: The prevalence of most minor cardiovascular manifestations in Marfan syndrome (MFS) is unknown. We assessed the prevalence of minor cardiovascular manifestations in MFS to evaluate their usefulness in a diagnostic setting. METHODS: Seventy-seven patients with MFS (aged 4 months to 55 years) underwent echocardiography to assess the presence of mitral valve prolapse and the diameter of the main pulmonary artery. A subset of 29 adult patients with MFS also underwent magnetic resonance imaging evaluation of the diameters of the thoracoabdominal aorta. RESULTS: Mitral valve prolapse was encountered in 66{\%} of patients with MFS, with an equal distribution of classic and nonclassic mitral valve prolapse. The main pulmonary artery diameter was significantly larger in patients with MFS at all ages when compared with controls. In the adult group (≥14 years), we were able to provide a cutoff value of 23 mm to define pulmonary artery dilatation. The descending aorta was enlarged, but with substantial overlap with controls, thus precluding the use of a cutoff value. CONCLUSIONS: Mitral valve prolapse and main pulmonary artery dilatation are common findings in MFS patients at all ages and are easy to assess with echocardiography. Cutoff values to define dilatation of the descending aorta are hard to define, making them of limited value in the diagnostic evaluation. We recommend echocardiographic evaluation of mitral valve proplase and main pulmonary artery diameter in patients referred for cardiovascular diagnostic assessment for MFS.",
keywords = "Cardiovascular, Diagnostic criteria, Marfan syndrome",
author = "{De Backer}, Julie and Bart Loeys and Dan Devos and Dietz, {Harry C} and {De Sutter}, Johan and {De Paepe}, Anne",
year = "2006",
month = "7",
doi = "10.1097/01.gim.0000223550.41849.e3",
language = "English (US)",
volume = "8",
pages = "401--408",
journal = "Genetics in Medicine",
issn = "1098-3600",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - A critical analysis of minor cardiovascular criteria in the diagnostic evaluation of patients with Marfan syndrome

AU - De Backer, Julie

AU - Loeys, Bart

AU - Devos, Dan

AU - Dietz, Harry C

AU - De Sutter, Johan

AU - De Paepe, Anne

PY - 2006/7

Y1 - 2006/7

N2 - PURPOSE: The prevalence of most minor cardiovascular manifestations in Marfan syndrome (MFS) is unknown. We assessed the prevalence of minor cardiovascular manifestations in MFS to evaluate their usefulness in a diagnostic setting. METHODS: Seventy-seven patients with MFS (aged 4 months to 55 years) underwent echocardiography to assess the presence of mitral valve prolapse and the diameter of the main pulmonary artery. A subset of 29 adult patients with MFS also underwent magnetic resonance imaging evaluation of the diameters of the thoracoabdominal aorta. RESULTS: Mitral valve prolapse was encountered in 66% of patients with MFS, with an equal distribution of classic and nonclassic mitral valve prolapse. The main pulmonary artery diameter was significantly larger in patients with MFS at all ages when compared with controls. In the adult group (≥14 years), we were able to provide a cutoff value of 23 mm to define pulmonary artery dilatation. The descending aorta was enlarged, but with substantial overlap with controls, thus precluding the use of a cutoff value. CONCLUSIONS: Mitral valve prolapse and main pulmonary artery dilatation are common findings in MFS patients at all ages and are easy to assess with echocardiography. Cutoff values to define dilatation of the descending aorta are hard to define, making them of limited value in the diagnostic evaluation. We recommend echocardiographic evaluation of mitral valve proplase and main pulmonary artery diameter in patients referred for cardiovascular diagnostic assessment for MFS.

AB - PURPOSE: The prevalence of most minor cardiovascular manifestations in Marfan syndrome (MFS) is unknown. We assessed the prevalence of minor cardiovascular manifestations in MFS to evaluate their usefulness in a diagnostic setting. METHODS: Seventy-seven patients with MFS (aged 4 months to 55 years) underwent echocardiography to assess the presence of mitral valve prolapse and the diameter of the main pulmonary artery. A subset of 29 adult patients with MFS also underwent magnetic resonance imaging evaluation of the diameters of the thoracoabdominal aorta. RESULTS: Mitral valve prolapse was encountered in 66% of patients with MFS, with an equal distribution of classic and nonclassic mitral valve prolapse. The main pulmonary artery diameter was significantly larger in patients with MFS at all ages when compared with controls. In the adult group (≥14 years), we were able to provide a cutoff value of 23 mm to define pulmonary artery dilatation. The descending aorta was enlarged, but with substantial overlap with controls, thus precluding the use of a cutoff value. CONCLUSIONS: Mitral valve prolapse and main pulmonary artery dilatation are common findings in MFS patients at all ages and are easy to assess with echocardiography. Cutoff values to define dilatation of the descending aorta are hard to define, making them of limited value in the diagnostic evaluation. We recommend echocardiographic evaluation of mitral valve proplase and main pulmonary artery diameter in patients referred for cardiovascular diagnostic assessment for MFS.

KW - Cardiovascular

KW - Diagnostic criteria

KW - Marfan syndrome

UR - http://www.scopus.com/inward/record.url?scp=33747889618&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33747889618&partnerID=8YFLogxK

U2 - 10.1097/01.gim.0000223550.41849.e3

DO - 10.1097/01.gim.0000223550.41849.e3

M3 - Article

VL - 8

SP - 401

EP - 408

JO - Genetics in Medicine

JF - Genetics in Medicine

SN - 1098-3600

IS - 7

ER -