Does medical therapy for thoracic aortic aneurysms really work? Are β-blockers truly indicated? CON

Cardiology Clinics

Volumn 28, Issue 2, 2010, Pages 261-269

  Liao, Steve L ^a,b   Elmariah, Sammy ^b   van der Zee, Sarina ^b   Sealove, Brett A ^b   Fuster, Valentin ^b,c  

^a VETERANS AFFAIRS MEDICAL CENTER   (United States)

^b MOUNT SINAI SCHOOL OF MEDICINE   (United States)

^c CENTRO NACIONAL DE INVESTIGACIONES CARDIOVASCULARES CNIC   (Spain)

Author keywords

Aortic aneurysm; Medical therapy; Blockers

Indexed keywords

ATORVASTATIN; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CERIVASTATIN; CHEMOKINE; CYTOKINE; DOXYCYCLINE; FIBRILLIN 1; GELATINASE B; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; LOSARTAN; MACROLIDE; MEVINOLIN; NEBIVOLOL; PLACEBO; PROPRANOLOL; PROSTAGLANDIN DERIVATIVE; ROXITHROMYCIN; SIMVASTATIN; TETRACYCLINE DERIVATIVE; TISSUE INHIBITOR OF METALLOPROTEINASE; TRANSFORMING GROWTH FACTOR BETA;

ABDOMINAL AORTA ANEURYSM; ANTIMICROBIAL ACTIVITY; APOPTOSIS; CLINICAL TRIAL; DYSPNEA; HUMAN; MARFAN SYNDROME; NONHUMAN; PATHOPHYSIOLOGY; PRIORITY JOURNAL; PROTEIN SYNTHESIS INHIBITION; RENIN ANGIOTENSIN ALDOSTERONE SYSTEM; REVIEW; THORACIC AORTA ANEURYSM; TREATMENT INDICATION; AORTIC ANEURYSM, THORACIC; BLOOD PRESSURE; DRUG EFFECTS; HEART STROKE VOLUME; TREATMENT OUTCOME;

ADRENERGIC BETA-ANTAGONISTS; AORTIC ANEURYSM, THORACIC; BLOOD PRESSURE; HUMANS; STROKE VOLUME; TREATMENT OUTCOME;

EID: 77952629536     PISSN: 07338651     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.ccl.2010.01.002     Document Type: Review

References (73)

1. Agmon Y., Khandheria B.K., Meissner I., et al. Is aortic dilatation an atherosclerosis-related process? Clinical, laboratory, and transesophageal echocardiographic correlates of thoracic aortic dimensions in the population with implications for thoracic aortic aneurysm formation. J Am Coll Cardiol 2003, 42(6):1076-1083.
2. Nataatmadja M., West J., West M. Overexpression of transforming growth factor-beta is associated with increased hyaluronan content and impairment of repair in Marfan syndrome aortic aneurysm. Circulation 2006, 114(Suppl 1):I371-I377.
3. El-Hamamsy I., Yacoub M.H. Cellular and molecular mechanisms of thoracic aortic aneurysms. Nat Rev Cardiol 2009, 6(12):771-786.
4. Kadoglou N.P., Liapis C.D. Matrix metalloproteinases: contribution to pathogenesis, diagnosis, surveillance and treatment of abdominal aortic aneurysms. Curr Med Res Opin 2004, 20(4):419-432.
5. O'Rourke M.F., Hashimoto J. Mechanical factors in arterial aging: a clinical perspective. J Am Coll Cardiol 2007, 50(1):1-13.
6. Elefteriades J.A. Acute aortic diseases 2007, Taylor & Francis, Inc, New York. 1st edition.
7. Knox J.B., Sukhova G.K., Whittemore A.D., et al. Evidence for altered balance between matrix metalloproteinases and their inhibitors in human aortic diseases. Circulation 1997, 95(1):205-212.
8. Pyo R., Lee J.K., Shipley J.M., et al. Targeted gene disruption of matrix metalloproteinase-9 (gelatinase B) suppresses development of experimental abdominal aortic aneurysms. J Clin Invest 2000, 105(11):1641-1649.
9. Tamarina N.A., McMillan W.D., Shively V.P., et al. Expression of matrix metalloproteinases and their inhibitors in aneurysms and normal aorta. Surgery 1997, 122(2):264-271. [discussion: 271-2].
10. Shah P.K. Inflammation, metalloproteinases, and increased proteolysis: an emerging pathophysiological paradigm in aortic aneurysm. Circulation 1997, 96(7):2115-2117.
11. Herron G.S., Unemori E., Wong M., et al. Connective tissue proteinases and inhibitors in abdominal aortic aneurysms. Involvement of the vasa vasorum in the pathogenesis of aortic aneurysms. Arterioscler Thromb 1991, 11(6):1667-1677.
12. Baxter B.T., McGee G.S., Shively V.P., et al. Elastin content, cross-links, and mRNA in normal and aneurysmal human aorta. J Vasc Surg 1992, 16(2):192-200.
13. Sakalihasan N., Heyeres A., Nusgens B.V., et al. Modifications of the extracellular matrix of aneurysmal abdominal aortas as a function of their size. Eur J Vasc Surg 1993, 7(6):633-637.
14. Dobrin P.B., Mrkvicka R. Failure of elastin or collagen as possible critical connective tissue alterations underlying aneurysmal dilatation. Cardiovasc Surg 1994, 2(4):484-488.
15. Satta J., Juvonen T., Haukipuro K., et al. Increased turnover of collagen in abdominal aortic aneurysms, demonstrated by measuring the concentration of the aminoterminal propeptide of type III procollagen in peripheral and aortal blood samples. J Vasc Surg 1995, 22(2):155-160.
16. Elefteriades J. Acute aortic disease 2007, Informa Healthcare USA, Inc, New York.
17. Lim D.S., Lutucuta S., Bachireddy P., et al. Angiotensin II blockade reverses myocardial fibrosis in a transgenic mouse model of human hypertrophic cardiomyopathy. Circulation 2001, 103(6):789-791.
18. Lavoie P., Robitaille G., Agharazii M., et al. Neutralization of transforming growth factor-beta attenuates hypertension and prevents renal injury in uremic rats. J Hypertens 2005, 23(10):1895-1903.
19. Brooke B.S., Habashi J.P., Judge D.P., et al. Angiotensin II blockade and aortic-root dilation in Marfan's syndrome. N Engl J Med 2008, 358(26):2787-2795.
20. Prokop E.K., Palmer R.F., Wheat M.W. Hydrodynamic forces in dissecting aneurysms. In-vitro studies in a Tygon model and in dog aortas. Circ Res 1970, 27(1):121-127.
21. Sanz J., Einstein A.J., Fuster V. Acute aortic dissection: anti-impulse therapy 2007, Taylor & Francis, Inc, New York.
22. Gersony D.R., McClaughlin M.A., Jin Z., et al. The effect of beta-blocker therapy on clinical outcome in patients with Marfan's syndrome: a meta-analysis. Int J Cardiol 2007, 114(3):303-308.
23. Shores J., Berger K.R., Murphy E.A., et al. Progression of aortic dilatation and the benefit of long-term beta-adrenergic blockade in Marfan's syndrome. N Engl J Med 1994, 330(19):1335-1341.
24. Gambarin F.I., Favalli V., Serio A., et al. Rationale and design of a trial evaluating the effects of losartan vs. nebivolol vs. the association of both on the progression of aortic root dilation in Marfan syndrome with FBN1 gene mutations. J Cardiovasc Med (Hagerstown) 2009, 10(4):354-362.
25. Boucek R.J., Gunja-Smith Z., Noble N.L., et al. Modulation by propranolol of the lysyl cross-links in aortic elastin and collagen of the aneurysm-prone turkey. Biochem Pharmacol 1983, 32(2):275-280.
26. Brophy C.M., Tilson J.E., Tilson M.D. Propranolol stimulates the crosslinking of matrix components in skin from the aneurysm-prone blotchy mouse. J Surg Res 1989, 46(4):330-332.
27. Simpson C.F., Kling J.M., Palmer R.F. Beta-aminopropionitrile-induced dissecting aneurysms of turkeys: treatment with propranolol. Toxicol Appl Pharmacol 1970, 16(1):143-153.
28. Gadowski G.R., Pilcher D.B., Ricci M.A. Abdominal aortic aneurysm expansion rate: effect of size and beta-adrenergic blockade. J Vasc Surg 1994, 19(4):727-731.
29. Leach S.D., Toole A.L., Stern H., et al. Effect of beta-adrenergic blockade on the growth rate of abdominal aortic aneurysms. Arch Surg 1988, 123(5):606-609.
30. Cronenwett J.L., Sargent S.K., Wall M.H., et al. Variables that affect the expansion rate and outcome of small abdominal aortic aneurysms. J Vasc Surg 1990, 11(2):260-268. [discussion: 268-9].
31. Biancari F., Mosorin M., Anttila V., et al. Ten-year outcome of patients with very small abdominal aortic aneurysm. Am J Surg 2002, 183(1):53-55.
32. Wilmink A.B., Vardulaki K.A., Hubbard C.S., et al. Are antihypertensive drugs associated with abdominal aortic aneurysms?. J Vasc Surg 2002, 36(4):751-757.
33. Propranolol Aneurysm Trial Investigators Propranolol for small abdominal aortic aneurysms: results of a randomized trial. J Vasc Surg 2002, 35(1):72-79.
34. Lindholt J.S., Henneberg E.W., Juul S., et al. Impaired results of a randomised double blinded clinical trial of propranolol versus placebo on the expansion rate of small abdominal aortic aneurysms. Int Angiol 1999, 18(1):52-57.
35. Elefteriades J.A. Thoracic aortic aneurysm: reading the enemy's playbook. Curr Probl Cardiol 2008, 33(5):203-277.
36. Luan Z., Chase A.J., Newby A.C. Statins inhibit secretion of metalloproteinases-1, -2, -3, and -9 from vascular smooth muscle cells and macrophages. Arterioscler Thromb Vasc Biol 2003, 23(5):769-775.
37. Wilson W.R., Evans J., Bell P.R., et al. HMG-CoA reductase inhibitors (statins) decrease MMP-3 and MMP-9 concentrations in abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 2005, 30(3):259-262.
38. Abisi S., Burnand K.G., Humphries J., et al. Effect of statins on proteolytic activity in the wall of abdominal aortic aneurysms. Br J Surg 2008, 95(3):333-337.
39. Evans J., Powell J.T., Schwalbe E., et al. Simvastatin attenuates the activity of matrix metalloprotease-9 in aneurysmal aortic tissue. Eur J Vasc Endovasc Surg 2007, 34(3):302-303.
40. Ejiri J., Inoue N., Tsukube T., et al. Oxidative stress in the pathogenesis of thoracic aortic aneurysm: protective role of statin and angiotensin II type 1 receptor blocker. Cardiovasc Res 2003, 59(4):988-996.
41. Shiraya S., Miyake T., Aoki M., et al. Inhibition of development of experimental aortic abdominal aneurysm in rat model by atorvastatin through inhibition of macrophage migration. Atherosclerosis 2009, 202(1):34-40.
42. Steinmetz E.F., Buckley C., Shames M.L., et al. Treatment with simvastatin suppresses the development of experimental abdominal aortic aneurysms in normal and hypercholesterolemic mice. Ann Surg 2005, 241(1):92-101.
43. Kalyanasundaram A., Elmore J.R., Manazer J.R., et al. Simvastatin suppresses experimental aortic aneurysm expansion. J Vasc Surg 2006, 43(1):117-124.
44. Sukhija R., Aronow W.S., Sandhu R., et al. Mortality and size of abdominal aortic aneurysm at long-term follow-up of patients not treated surgically and treated with and without statins. Am J Cardiol 2006, 97(2):279-280.
45. Schouten O., van Laanen J.H., Boersma E., et al. Statins are associated with a reduced infrarenal abdominal aortic aneurysm growth. Eur J Vasc Endovasc Surg 2006, 32(1):21-26.
46. Nieto F.J. Infective agents and cardiovascular disease. Semin Vasc Med 2002, 2(4):401-415.
47. Lindholt J.S., Ashton H.A., Scott R.A. Indicators of infection with Chlamydia pneumoniae are associated with expansion of abdominal aortic aneurysms. J Vasc Surg 2001, 34(2):212-215.
48. Curci J.A., Mao D., Bohner D.G., et al. Preoperative treatment with doxycycline reduces aortic wall expression and activation of matrix metalloproteinases in patients with abdominal aortic aneurysms. J Vasc Surg 2000, 31(2):325-342.
49. Vammen S., Lindholt J.S., Ostergaard L., et al. Randomized double-blind controlled trial of roxithromycin for prevention of abdominal aortic aneurysm expansion. Br J Surg 2001, 88(8):1066-1072.
50. Golub L.M., Lee H.M., Lehrer G., et al. Minocycline reduces gingival collagenolytic activity during diabetes. Preliminary observations and a proposed new mechanism of action. J Periodont Res 1983, 18(5):516-526.
51. Golub L.M., Lee H.M., Ryan M.E., et al. Tetracyclines inhibit connective tissue breakdown by multiple non-antimicrobial mechanisms. Adv Dent Res 1998, 12(2):12-26.
52. Greenwald R.A. Treatment of destructive arthritic disorders with MMP inhibitors. Potential role of tetracyclines. Ann N Y Acad Sci 1994, 732:181-198.
53. Longo G.M., Buda S.J., Fiotta N., et al. MMP-12 has a role in abdominal aortic aneurysms in mice. Surgery 2005, 137(4):457-462.
54. Curci J.A., Petrinec D., Liao S., et al. Pharmacologic suppression of experimental abdominal aortic aneurysms: a comparison of doxycycline and four chemically modified tetracyclines. J Vasc Surg 1998, 28(6):1082-1093.
55. Petrinec D., Liao S., Holmes D.R., et al. Doxycycline inhibition of aneurysmal degeneration in an elastase-induced rat model of abdominal aortic aneurysm: preservation of aortic elastin associated with suppressed production of 92 kD gelatinase. J Vasc Surg 1996, 23(2):336-346.
56. Prall A.K., Longo G.M., Mayhan W.G., et al. Doxycycline in patients with abdominal aortic aneurysms and in mice: comparison of serum levels and effect on aneurysm growth in mice. J Vasc Surg 2002, 35(5):923-929.
57. Baxter B.T., Pearce W.H., Waltke E.A., et al. Prolonged administration of doxycycline in patients with small asymptomatic abdominal aortic aneurysms: report of a prospective (Phase II) multicenter study. J Vasc Surg 2002, 36(1):1-12.
58. Mosorin M., Juvonen J., Biancari F., et al. Use of doxycycline to decrease the growth rate of abdominal aortic aneurysms: a randomized, double-blind, placebo-controlled pilot study. J Vasc Surg 2001, 34(4):606-610.
59. Dalsing M.C., Lalka S.G., Sawchuk A.P., et al. Vascular medicine. Textbook of internal medicine 1997, Lippincott-Raven Publishers, Philadelphia. W.N. Kelley (Ed.).
60. Bickerstaff L.K., Pairolero P.C., Hollier L.H., et al. Thoracic aortic aneurysms: a population-based study. Surgery 1982, 92(6):1103-1108.
61. Bickerstaff L.K., Hollier L.H., Van Peenen H.J., et al. Abdominal aortic aneurysms: the changing natural history. J Vasc Surg 1984, 1(1):6-12.
62. Golledge J., Muller J., Daugherty A., et al. Abdominal aortic aneurysm: pathogenesis and implications for management. Arterioscler Thromb Vasc Biol 2006, 26(12):2605-2613.
63. Kuivaniemi H., Platsoucas C.D., Tilson M.D. Aortic aneurysms: an immune disease with a strong genetic component. Circulation 2008, 117(2):242-252.
64. Nordon I., Brar R., Taylor J., et al. Evidence from cross-sectional imaging indicates abdominal but not thoracic aortic aneurysms are local manifestations of a systemic dilating diathesis. J Vasc Surg 2009, 50(1):171-176. e171.
65. Thompson R.W. Reflections on the pathogenesis of abdominal aortic aneurysms. Cardiovasc Surg 2002, 10(4):389-394.
66. Kielty C.M. Elastic fibres in health and disease. Expert Rev Mol Med 2006, 8(19):1-23.
67. Isogai Z., Ono R.N., Ushiro S., et al. Latent transforming growth factor beta-binding protein 1 interacts with fibrillin and is a microfibril-associated protein. J Biol Chem 2003, 278(4):2750-2757.
68. Neptune E.R., Frischmeyer P.A., Arking D.E., et al. Dysregulation of TGF-beta activation contributes to pathogenesis in Marfan syndrome. Nat Genet 2003, 33(3):407-411.
69. Habashi J.P., Judge D.P., Holm T.M., et al. Losartan, an AT1 antagonist, prevents aortic aneurysm in a mouse model of Marfan syndrome. Science 2006, 312(5770):117-121.
70. Nataatmadja M., West M., West J., et al. Abnormal extracellular matrix protein transport associated with increased apoptosis of vascular smooth muscle cells in Marfan syndrome and bicuspid aortic valve thoracic aortic aneurysm. Circulation 2003, 108(Suppl 1):II329-II334.
71. Ikonomidis J.S., Jones J.A., Barbour J.R., et al. Expression of matrix metalloproteinases and endogenous inhibitors within ascending aortic aneurysms of patients with Marfan syndrome. Circulation 2006, 114(Suppl 1):I365-I370.
72. Chung A.W., Au Yeung K., Sandor G.G., et al. Loss of elastic fiber integrity and reduction of vascular smooth muscle contraction resulting from the upregulated activities of matrix metalloproteinase-2 and -9 in the thoracic aortic aneurysm in Marfan syndrome. Circ Res 2007, 101(5):512-522.
73. Davies R.R., Goldstein L.J., Coady M.A., et al. Yearly rupture or dissection rates for thoracic aortic aneurysms: simple prediction based on size. Ann Thorac Surg 2002, 73(1):17-27. [discussion: 27-8].