Marfan’s syndrome – inheritance, diagnostic methods, management in disease
DOI:
https://doi.org/10.12775/QS.2023.14.01.001Keywords
Marfan's syndorme, MFS, FBN1, aortic aneurysm, losartanAbstract
Introduction: Marfan’s syndrome (MFS) is a systemic, autosomal dominant connective tissue disease. It is caused mainly by the mutations in the FBN1 gene and is connected with extracellular matrix protein fibrillin-1. The incidence is about 2-3 per 10 000. About 70-75% of cases are inherited in an autosomal dominant fashion and the remaining are de-novo mutations.
The aim of the study: This study aims to gather current knowledge about inheritance, diagnostic methods and management in Marfan syndrome.
Materials and methods: This review was based on available data collected in the PubMed database and Google Scholar web search engine, using the key words: Marfan’s syndrome. MFS, FBN1, aortic aneurysm, Marfan Foundation
Conclusion: The diagnosis of Marfan’s syndrome requires detailed assessment of the body build, concomitant diseases and, above all, genetic history of the patient. Connective tissue mutations can develop at any time, and already existing defects can exacerbate. Physicians should pay particular attention while examining patients with suspected MFS. Already diagnosed patients should be checked regularly to quickly find possible complications. There is no casual treatment, multidirectional preventive therapeutic treatment is used.
References
Castellano J, Silvay G, Castillo J: Marfan Syndrome. Clinical, Surgical, and Anesthetic Considerations. Semin Cardiothorac Vasc Anesth 2014; 18(3): 260-271.
Canadas V, Vilacosta I, Bruna I, Fuster V: Marfan syndrome, part 1: pathophysiology and diagnosis. Nat Rev Cardiol 2010; 7: 256-265.
Judge D, Dietz H: The Marfan’s syndrome. Lancet 2005; 366: 1965-1976.
Milewicz DM, Braverman AC, De Backer J, Morris SA, Boileau C, Maumenee IH, Jondeau G, Evangelista A, Pyeritz RE. Marfan syndrome. Nat Rev Dis Primers. 2021 Sep 2;7(1):64. doi: 10.1038/s41572-021-00298-7. Erratum in: Nat Rev Dis Primers. 2022 Jan 17;8(1):3. PMID: 34475413; PMCID: PMC9261969.
Williams E. Rare cases, with practical remarks. Trans Am Ophthalmol Soc. 1875; 2: 291–301, indexed in Pubmed: 25258802.
Marfan A. Un cas de déformation congénitgale des quatres membres, plus prononcée aux extremités, caractérisée par l’allongement des os avec un certain degré d’amincissiment. Bulletins et memoires de la Société medicale des hôpitaux de Paris. 1896; 13: 220–228.
Ruettimann B, Steinmann BA. Marfan his life and times. Europ J Pediat. 1996; 155: 725–726.
Baer RW, Taussig HB, Oppenheimer EH. Congenital aneurysmal dilatation of the aorta associated with arachnodactyly. Bull Hopkins Hosp. 1943; 72: 309–331.
Etter LE, Glover LP. Arachnodactyly complicated by dislocated lens and death from rupture of dissecting aneurysm of the aorta. JAMA. 1943; 23: 88–89.
McKusick VA. The cardiovascular aspects of Marfan’s syndrome: a heritable disorder of connective tissue. Circulation. 1955; 11(3): 321–342, indexed in Pubmed: 14352380.
Murdoch JL, Walker BA, Halpern BL, Kuzma JW & McKusick VA Life expectancy and causes of death in the Marfan syndrome. N. Engl. J Med 286, 804–808 (1972).
Pyeritz RE The Marfan syndrome. Annu. Rev. Med 51, 481–510 (2000).
Curry EA, Gelson E, Swan L et al.: Marfan syndrome and pregnancy: maternal and neonatal outcomes. BJOG 2014; 121: 610–617.
Vlahos NF, Triantafyllidou O, Vitoratos N et al.: Preimplantation genetic diagnosis in Marfan syndrome. Case Rep Obstet Gynecol 2013; 2013: 542961.
Loeys BL, Dietz HC, Braverman AC, Callewaert BL, De Backer J, Devereux RB, Hilhorst-Hofstee Y, Jondeau G, Faivre L, Milewicz DM, Pyeritz RE, Sponseller PD, Wordsworth P, De Paepe AM. The revised Ghent nosology for the Marfan syndrome. J Med Genet. 2010 Jul;47(7):476-85. doi: 10.1136/jmg.2009.072785. PMID: 20591885.
Nomograms for Aortic Root Diameters in Children Using Two-Dimensional Echocardiography. Gautier M, Detaint D, Fermanian C, Aegerter P, Delorme G, Arnoult F, Milleron O, Raoux F, Stheneur C, Boileau C, Vahanian A, Jondeau G. Am J Cardiol. 2010 Mar 15;105(6):888-894.
Selamet Tierney ES, Levine JC, Chen S, Bradley TJ, Pearson GD, Colan SD, Sleeper LA, Campbell MJ, Cohen MS, De Backer J, Guey LT, Heydarian H, Lai WW, Lewin MB, Marcus E, Mart CR, Pignatelli RH, Printz BF, Sharkey AM, Shirali GS, Srivastava S, Lacro RV; Pediatric Heart Network Investigators. Echocardiographic methods, quality review, and measurement accuracy in a randomized multicenter clinical trial of Marfan syndrome. J Am Soc Echocardiogr. 2013 Jun;26(6):657-66. doi: 10.1016/j.echo.2013.02.018. Epub 2013 Apr 10. PMID: 23582510; PMCID: PMC3779059.
Veldhoen S et al. Exact monitoring of aortic diameters in Marfan patients without gadolinium contrast: intraindividual comparison of 2D SSFP imaging with 3D CE-MRA and echocardiography. Eur. Radiol 25, 872–882, doi: 10.1007/s00330-014-3457-6 [doi] (2015).
Erbel R et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur. Heart J 35, 2873–2926, doi:ehu281 [pii]; 10.1093/eurheartj/ehu281 [doi] (2014).
Hiratzka LF et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation 121, e266–e369 (2010).
Weinrich JM et al. Reliability of non-contrast magnetic resonance angiography-derived aortic diameters in Marfan patients: comparison of inner vs. outer vessel wall measurements. Int J Cardiovasc Imaging 36, 1533–1542, doi: 10.1007/s10554-020-01850-4 (2020).
Redlinger RE Jr. et al. Minimally invasive repair of pectus excavatum in patients with Marfan syndrome and marfanoid features. J Pediatr Surg 45, 193–199, doi: 10.1016/j.jpedsurg.2009.10.037 (2010).
Sponseller PD, Hobbs W, Riley LH 3rd & Pyeritz RE The thoracolumbar spine in Marfan syndrome. J Bone Joint Surg Am 77, 867–876, doi: 10.2106/00004623-199506000-00007 (1995).
Xu W et al. Comparative data on SD-OCT for the retinal nerve fiber layer and retinal macular thickness in a large cohort with Marfan syndrome. Ophthalmic Genet 38, 34–38, doi: 10.1080/13816810.2016.1275017 (2017).
Braverman AC, Harris KM, Kovacs RJ & Maron BJ Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 7: Aortic Diseases, Including Marfan Syndrome: A Scientific Statement From the American Heart Association and American College of Cardiology. J Am Coll Cardiol 66, 2398–2405, doi:S0735–1097(15)06575–4 [pii]; 10.1016/j.jacc.2015.09.039 [doi] (2015).
Habashi JP, Judge DP, Holm TM, et al. Losartan, an AT1 antagonist, prevents aortic aneurysm in a mouse model of Marfan syndrome. Science. 2006; 312(5770): 117–121, doi: 10.1126/science.1124287, indexed in Pubmed: 16601194.
Groenink M et al. Losartan reduces aortic dilatation rate in adults with Marfan syndrome: a randomized controlled trial. Eur. Heart J 34, 3491–3500, doi:eht334 [pii]; 10.1093/eurheartj/eht334 [doi] (2013).
Mullen M et al. Irbesartan in Marfan syndrome (AIMS): a double-blind, placebo-controlled randomised trial. Lancet 394, 2263–2270, doi:S0140–6736(19)32518–8 [pii]; 10.1016/S0140-6736(19)32518-8 [doi] (2020).
Milleron O et al. Marfan Sartan: a randomized, double-blind, placebo-controlled trial. Eur. Heart J 36, 2160–2166, doi:ehv151 [pii]; 10.1093/eurheartj/ehv151 [doi] (2015).
David TE et al. Outcomes of Aortic Valve-Sparing Operations in Marfan Syndrome. J. Am. Coll. Cardiol 66, 1445–1453, doi:S0735–1097(15)04597–0 [pii]; 10.1016/j.jacc.2015.07.041 [doi] (2015).
Izgi C et al. External Aortic Root Support to Prevent Aortic Dilatation in Patients With Marfan Syndrome. J Am Coll Cardiol 72, 1095–1105, doi:S0735–1097(18)35445–7 [pii]; 10.1016/j.jacc.2018.06.053 [doi] (2018).
Shalhub S et al. Type B Aortic Dissection in Young Individuals With Confirmed and Presumed Heritable Thoracic Aortic Disease. Ann. Thorac. Surg 109, 534–540, doi:S0003–4975(19)31066–5 [pii]; 10.1016/j.athoracsur.2019.07.004 [doi] (2020).
The Marfan Foundation. Survey Results Reveal Greatest Obstacles to Quality of Life The Marfan Foundation https://marfan.org/2017/11/01/survey-results-reveal-greatest-obstacles-to-quality-of-life/ (2017)
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