Quick Fire Session
SCMR 22nd Annual Scientific Sessions
The most common cardiovascular complications of Marfan syndrome (MFS) are aortic root dilation and type A aortic dissection. Nowadays, MFS patients require a close follow-up of aortic root diameter and preventive aortic root surgery in case of severe or fast-progressing dilation. Despite Guidelines use aortic diameter to indicate surgery, the capacity of this parameter to predict complications is limited. For that reason, new non-invasive biomarkers to improve risk stratification are needed. We studied the capacity of proximal aorta circumferential and longitudinal strain and ascending aorta distensibility to predict aortic root diameter expansion and incidence of aortic events in Marfan patients.
A cohort of eighty seven Marfan patients without previous cardiac/aortic surgery or dissection were prospectively included in a multicenter follow-up. Baseline CMR was used to calculate proximal aorta longitudinal and circumferential strain and distensibility.
During a follow-up of 81.6 ± 17 months, mean dilation rate was 0.65 ± 0.67 mm/year and z-score growth rate 0.07 ± 0.13 1/year. Type A aortic dissection appeared in 2 patients and elective aortic root replacement was required in 11 patients. Proximal aorta longitudinal strain but not circumferential strain and distensibility were independent predictors of diameter growth-rate (p=0.001, p=0.385 and p=0.381, respectively), z-score growth-rate (p=0.018, p=0.515 and p=0.484, respectively) and major aortic events (p=0.018, p=0.064 and p=0.205, respectively), in a multivariable analysis corrected for demographic and clinical characteristics, and baseline aortic root diameter.
Proximal aorta longitudinal strain is an independent predictor of aortic root expansion and major cardiovascular events beyond aortic root diameter and risk factors, in Marfan syndrome.