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Volume 359:1732-1734 October 16, 2008 Number 16
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Angiotensin II Blockade in Marfan's Syndrome

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by Brooke, B. S.
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To the Editor: Brooke et al. (June 26 issue),1 report a reduced rate of aortic-root dilation among pediatric patients with Marfan's syndrome after treatment with angiotensin II–receptor blockers (ARBs) as compared with previous medical therapy alone. This finding may be related to the inhibition of excessive transforming growth factor β (TGF-β) signaling2 and the subsequent inhibition of matrix metalloproteinases, thus reducing extracellular-matrix degeneration and aortic dilation.3 We recently reported the results of a randomized, placebo-controlled trial, which showed that an angiotensin-converting–enzyme (ACE) inhibitor, perindopril, reduced aortic dilation in adult patients with Marfan's syndrome after only 6 months.4 The article by . . . [Full Text of this Article]



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