Long-term outcome in patients with Marfan syndrome: is aortic dissection the only cause of sudden death?

J Am Coll Cardiol. 2003 Jan 15;41(2):329-32. doi: 10.1016/s0735-1097(02)02699-2.

Abstract

Objectives: We sought to assess outcomes in a series of young patients with Marfan syndrome and to define the prevalence of ventricular arrhythmias in this patient population.

Background: While sudden death is a well-recognized outcome in Marfan syndrome, ventricular arrhythmias are not well described.

Methods: Patients were followed with echocardiography, electrocardiography, and ambulatory electrocardiography. The prevalence and associated factors for ventricular dysrhythmias were defined.

Results: Seventy patients with Marfan syndrome diagnosed at birth to 52 years were followed for a period of up to 24 years. All patients had cardiovascular involvement and were started on medical therapy. No patient died from aortic dissection, while 4% died from arrhythmias. Ventricular arrhythmias were present in 21% and were associated with increased left ventricular size, mitral valve prolapse, and abnormalities of repolarization.

Conclusions: Cardiac complications are rare in young patients with Marfan syndrome receiving medical therapy and close clinical follow-up. Sudden death still occurs, and appears more common in patients with a dilated left ventricle. Left ventricular dilation may predispose to alterations of repolarization and fatal ventricular arrhythmias.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Arrhythmias, Cardiac / epidemiology*
  • Arrhythmias, Cardiac / etiology
  • Arrhythmias, Cardiac / mortality
  • Child
  • Child, Preschool
  • Death, Sudden, Cardiac / etiology*
  • Echocardiography
  • Electrocardiography, Ambulatory
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Logistic Models
  • Male
  • Marfan Syndrome / complications*
  • Marfan Syndrome / diagnostic imaging
  • Marfan Syndrome / mortality
  • Middle Aged
  • Prevalence
  • Prognosis
  • Survival Analysis