Atenolol versus Losartan in Children and Young Adults with Marfan’s Syndrome

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1、Thenewenglandjournalofmedicineestablishedin1812november27,2014vol.371no.22AtenololversusLosartaninChildrenandYoungAdultswithMarfan’sSyndromeR.V.Lacro,H.C.Dietz,L.A.Sleeper,A.T.Yetman,T.J.Bradley,S.D.Colan,G.D.Pearson,E.S.SelametTierney,J.C.Levine,A.M.Atz,D.W.Benson,A.C.Braverman,S.Chen,J.DeBacker

2、,B.D.Gelb,P.D.Grossfeld,G.L.Klein,W.W.Lai,A.Liou,B.L.Loeys,L.W.Markham,A.K.Olson,S.M.Paridon,V.L.Pemberton,M.E.Pierpont,R.E.Pyeritz,E.Radojewski,M.J.Roman,A.M.Sharkey,M.P.Stylianou,S.BurnsWechsler,L.T.Young,andL.Mahony,forthePediatricHeartNetworkInvestigators*ABSTRACTBACKGROUNDAortic-rootdissecti

3、onistheleadingcauseofdeathinMarfan’ssyndrome.StudiesTheauthors’fullnames,academicde-suggestthatwithregardtoslowingaortic-rootenlargement,losartanmaybemoregrees,andaffiliationsarelistedintheAp-pendix.AddressreprintrequeststoDr.effectivethanbeta-blockers,thecurrentstandardtherapyinmostcenters.Lacro

4、attheDepartmentofCardiology,BostonChildren’sHospital,300Long-METHODSwoodAve.,Boston,MA02115-5724,oratron.lacro@cardio.chboston.org.WeconductedarandomizedtrialcomparinglosartanwithatenololinchildrenandyoungadultswithMarfan’ssyndrome.Theprimaryoutcomewastherateofaortic-*Acompletelistofinvestigators

5、inthePediatricHeartNetworkisprovidedinrootenlargement,expressedasthechangeinthemaximumaortic-root-diametertheSupplementaryAppendix,availablezscoreindexedtobody-surfacearea(hereafter,aortic-rootzscore)overa3-yearatNEJM.org.period.SecondaryoutcomesincludedtherateofchangeintheabsolutediameterofThisa

6、rticlewaspublishedonNovember18,theaorticroot;therateofchangeinaorticregurgitation;thetimetoaorticdissection,2014,atNEJM.org.aortic-rootsurgery,ordeath;somaticgrowth;andtheincidenceofadverseevents.NEnglJMed2014;371:2061-71.DOI:10.1056/NEJMoa1404731RESULTSCopyright?2014MassachusettsMedicalSociety.F

7、romJanuary2007throughFebruary2011,atotalof21clinicalcentersenrolled608participants,6monthsto25yearsofage(mean[±SD]age,11.5±6.5yearsintheatenololgroupand11.0±6.2yearsinthelosartangroup),whohadanaortic-rootzscoregreatert