PDF icon Download PDF
Open Access
CC BY-NC-ND 4.0 · Aorta (Stamford) 2023; 11(02): 063-070
DOI: 10.1055/a-2072-0469
Original Research Article

Beta-Blocker Use during Pregnancy Correlates with Less Aortic Root Dilatation in Patients with Marfan's Syndrome

Emma A. Roberts    #
1   Department of Obstetrics and Gynecology, University of California San Diego, San Diego, California
,
Andrew Pistner   #
2   Division of Cardiology, University of Washington, Seattle, Washington
,
Oyinkansola Osobamiro
3   Department of Medicine, University of Washington, Seattle, Washington
,
Stephanie Banning
4   Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
,
Sherene Shalhub
5   Division of Vascular Surgery, University of Washington, Seattle, Washington
,
Catherine Albright
6   Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington
,
Ofir Horovitz
7   School of Public Health, University of Washington, Seattle, Washington
,
Jonathan Buber
2   Division of Cardiology, University of Washington, Seattle, Washington
› Author Affiliations
Funding None.
› Further Information
Also available ateRef
  Permissions and Reprints
Preview

Abstract

Background Pregnant patients with Marfan's syndrome (MFS) are at an increased risk for adverse aortic outcomes. While beta-blockers are used to slow aortic root dilatation in nonpregnant MFS patients, the benefit of such therapy in pregnant MFS patients remains controversial. The purpose of this study was to investigate the effect of beta-blockers on aortic root dilatation during pregnancy in MFS patients.

Methods This was a longitudinal single-center retrospective cohort study of females with MFS who completed a pregnancy between 2004 and 2020. Clinical, fetal, and echocardiographic data were compared in patients on- versus off-beta-blockers during pregnancy.

Results A total of 20 pregnancies completed by 19 patients were evaluated. Beta-blocker therapy was initiated or continued in 13 (65%) of the 20 pregnancies. Pregnancies on-beta-blocker therapy experienced less aortic growth compared with those off-beta-blockers (0.10 [interquartile range, IQR: 0.10–0.20] vs. 0.30 cm [IQR: 0.25–0.35]; p = 0.03). Using univariate linear regression, maximum systolic blood pressures (SBP), increase in SBP, and absence of beta-blocker use in pregnancy were found to be significantly associated with greater increase in aortic diameter during pregnancy. There were no differences in rates of fetal growth restriction between pregnancies on- versus off-beta-blockers.

Conclusion This is the first study that we are aware of to evaluate changes in aortic dimensions in MFS pregnancies stratified by beta-blocker use. Beta-blocker therapy was found to be associated with less aortic root growth during pregnancy in MFS patients.

Keywords

Marfan's syndrome - pregnancy - beta-blockers - aorta - aortic dilation

# These authors contributed equally to this work.




Publication History

Received: 02 June 2022

Accepted: 07 April 2023

Accepted Manuscript online:
13 April 2023

Article published online:
31 May 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA