Cardiovascular manifestations in men and women carrying a FBN1 mutation

Delphine Détaint, Laurence Faivre, Gwenaelle Collod-Beroud, Anne H. Child, Bart L. Loeys, Christine Binquet, Elodie Gautier, Eloisa Arbustini, Karin Mayer, Mine Arslan-Kirchner, Chantal Stheneur, Dorothy Halliday, Christophe Beroud, Claire Bonithon-Kopp, Mireille Claustres, Henri Plauchu, Peter N. Robinson, Anatoli Kiotsekoglou, Julie De Backer, Lesley AdsUta Francke, Anne De Paepe, Catherine Boileau, Guillaume Jondeau

Research output: Contribution to journalArticlepeer-review

Abstract

AimsIn patients with Marfan syndrome and other type-1 fibrillinopathies, genetic testing is becoming more easily available, leading to the identification of mutations early in the course of the disease. This study evaluates the cardiovascular (CV) risk associated with the discovery of a fibrillin-1 (FBN1) mutation. Methods and resultsA total of 1013 probands with pathogenic FBN1 mutations were included, among whom 965 patients [median age: 22 years (11-34), male gender 53] had data suitable for analysis. The percentage of patients with an ascending aortic (AA) dilatation increased steadily with increasing age and reached 96 (95 CI: 94-97) by 60 years. The presence of aortic events (dissection or prophylactic surgery) was rare before 20 years and then increased progressively, reaching 74 (95 CI: 67-81) by 60 years. Compared with women, men were at higher risk for AA dilatation [≤30 years: 57 (95 CI: 52-63) vs. 50 (95 CI: 45-55), P = 0.0076] and aortic events [≤30 years: 21 (95 CI: 17-26) vs. 11 (95 CI: 8-16), P <0.0001; adjusted HR: 1.4 (1.1-1.8), P = 0.005]. The prevalence of mitral valve (MV) prolapse [≤60 years: 77 (95 CI: 72-82)] and MV regurgitation [≤60 years: 61 (95 CI: 53-69)] also increased steadily with age, but surgery limited to the MV remained rare [≤60 years: 13 (95 CI: 8-21)]. No difference between genders was observed (for all P> 0.20). From 1985 to 2005 the prevalence of AA dilatation remained stable (P for trend = 0.88), whereas the percentage of patients with AA dissection significantly decreased (P for trend = 0.01). ConclusionThe CV risk remains important in patients with an FBN1 gene mutation and is present throughout life, justifying regular aortic monitoring. Aortic dilatation or dissection should always trigger suspicion of a genetic background leading to thorough examination for extra-aortic features and comprehensive pedigree investigation.

Original languageEnglish
Pages (from-to)2223-2229
Number of pages7
JournalEuropean Heart Journal
Volume31
Issue number18
DOIs
Publication statusPublished - Sep 2010

Keywords

  • Aortic dilatation
  • Aortic dissection
  • Cardiovascular risk
  • FBN1 gene mutation
  • Marfan syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Cardiovascular manifestations in men and women carrying a FBN1 mutation'. Together they form a unique fingerprint.

Cite this