atenolol and Marfan Syndrome studies

Atenolol: A cardioselective beta-1 adrenergic blocker possessing properties and potency similar to PROPRANOLOL, but without a negative inotropic effect.
atenolol : An ethanolamine compound having a (4-carbamoylmethylphenoxy)methyl group at the 1-position and an N-isopropyl substituent.

Marfan Syndrome: An autosomal dominant disorder of CONNECTIVE TISSUE with abnormal features in the heart, the eye, and the skeleton. Cardiovascular manifestations include MITRAL VALVE PROLAPSE, dilation of the AORTA, and aortic dissection. Other features include lens displacement (ectopia lentis), disproportioned long limbs and enlarged DURA MATER (dural ectasia). Marfan syndrome (type 1) is associated with mutations in the gene encoding FIBRILLIN-1 (FBN1), a major element of extracellular microfibrils of connective tissue. Mutations in the gene encoding TYPE II TGF-BETA RECEPTOR (TGFBR2) are associated with Marfan syndrome type 2.

Research Excerpts

Excerpt	Relevance	Reference
"In a subset of 250 white, non-Hispanic participants with Marfan syndrome in a prior randomized trial of atenolol vs losartan, the common variants rs1801252 and rs1801253 in ADRB1 and rs1799853 and rs1057910 in CYP2C9 were analyzed."	9.34	Variants in ADRB1 and CYP2C9: Association with Response to Atenolol and Losartan in Marfan Syndrome. ( Dietz, HC; Forbus, GA; Gelb, BD; Goldmuntz, E; Hoskoppal, A; James, J; Lacro, RV; Lee, TM; Levine, JC; Li, JS; Loeys, BL; Markham, LW; Meester, JAN; Mital, S; Morris, SA; Mosley, JD; Olson, AK; Renard, M; Roden, DM; Shaffer, CM; Sharkey, A; Sleeper, LA; Van Driest, SL; Young, L, 2020)
"The aim of this study was to evaluate the effect of aliskiren on aortic stiffness in patients with Marfan syndrome (MS)."	9.27	Comparison of the Effect of Aliskiren Versus Negative Controls on Aortic Stiffness in Patients With Marfan Syndrome Under Treatment With Atenolol. ( Ahn, J; Carriere, K; Chang, SA; Choe, YH; Chung, TY; Hwang, JW; Jang, SY; Ki, CS; Kim, DK; Kim, EK; Kim, SM; Sung, K, 2018)
"Long-term outcome of Marfan syndrome patients randomly assigned to losartan or atenolol showed no differences in aortic dilation rate or presence of clinical events between treatment groups."	9.27	Losartan Versus Atenolol for Prevention of Aortic Dilation in Patients With Marfan Syndrome. ( Evangelista, A; Forteza, A; García-Dorado, D; González Mirelis, J; Gutiérrez, L; Ibáñez, B; Rodríguez-Palomares, J; Sánchez, V; Teixido-Tura, G, 2018)
" atenolol in aortic dilation progression in Marfan syndrome (MFS) patients."	9.22	Efficacy of losartan vs. atenolol for the prevention of aortic dilation in Marfan syndrome: a randomized clinical trial. ( Centeno, J; Cortina, J; Evangelista, A; Ferreira-González, I; Forteza, A; García-Dorado, D; Gracia, T; Gutiérrez, L; Rodríguez-Palomares, J; Rufilanchas, JJ; Sánchez, V; Sanz, P; Teixidó-Turà, G, 2016)
"We conducted a randomized, double-blind trial of losartan (100 mg QD) versus atenolol (50 mg QD) for 6 months in adults with Marfan syndrome."	9.20	Distinct effects of losartan and atenolol on vascular stiffness in Marfan syndrome. ( Bhatt, AB; Buck, JS; Creager, MA; Gauvreau, K; Kadivar, S; Milian, J; Singh, MN; Zuflacht, JP, 2015)
"The Pediatric Heart Network designed a clinical trial to compare aortic root growth and other short-term cardiovascular outcomes in children and young adults with Marfan syndrome randomized to receive atenolol or losartan."	9.17	Characteristics of children and young adults with Marfan syndrome and aortic root dilation in a randomized trial comparing atenolol and losartan therapy. ( Benson, DW; Bradley, TJ; De Backer, J; Dietz, HC; Forbus, GA; Gelb, BD; Guey, LT; Klein, GL; Lacro, RV; Lai, WW; Levine, JC; Lewin, MB; Loeys, BL; Mahony, L; Markham, LW; Paridon, SM; Pearson, GD; Pierpont, ME; Radojewski, E; Selamet Tierney, ES; Sharkey, AM; Wechsler, SB; Yetman, AT, 2013)
"To assess the tolerability and efficacy of the investigational use of the angiotensin II receptor blocker losartan added to β-blockade (BB) to prevent progressive aortic root dilation in patients with Marfan syndrome (MFS)."	9.17	Losartan added to β-blockade therapy for aortic root dilation in Marfan syndrome: a randomized, open-label pilot study. ( Chen, CA; Chiu, HH; Chiu, SN; Hu, FC; Lin, MT; Lu, CW; Wang, JK; Wu, MH, 2013)
"Beta-blockers, eg, atenolol, are the cornerstone therapy for thoracic aortic aneurysm (TAA) in patients with Marfan syndrome; however, continued aortic dilatation has been reported."	7.74	Long-term doxycycline is more effective than atenolol to prevent thoracic aortic aneurysm in marfan syndrome through the inhibition of matrix metalloproteinase-2 and -9. ( Chung, AW; Radomski, MW; van Breemen, C; Yang, HH, 2008)
"The negative inotropic and chronotropic effects of beta-blocker therapy have been reported to reduce morbidity and mortality in patients with Marfan syndrome; however, little is known about the pharmacokinetics of atenolol after oral administration of multiple doses to patients with the Marfan syndrome."	7.69	Absorption pharmacokinetics of atenolol in patients with the Marfan syndrome. ( Alpert, BS; Lima, JJ; Phelps, SJ; Pieper, JA; Ward, JL, 1995)
"Efficacy of losartan versus atenolol in the prevention of progressive dilation of the aorta, improved aortic distensibility, and prevention of adverse events (aortic dissection or rupture, cardiovascular surgery, or death) will be assessed in this study."	6.76	[Study of the efficacy and safety of losartan versus atenolol for aortic dilation in patients with Marfan syndrome]. ( Centeno, J; Cortina, J; Evangelista, A; Forteza, A; García, D; García-Dorado, D; Gutiérrez, L; Rodríguez-Palomares, J; Sánchez, V; Sanz, P; Teixidó, G, 2011)
"In a subset of 250 white, non-Hispanic participants with Marfan syndrome in a prior randomized trial of atenolol vs losartan, the common variants rs1801252 and rs1801253 in ADRB1 and rs1799853 and rs1057910 in CYP2C9 were analyzed."	5.34	Variants in ADRB1 and CYP2C9: Association with Response to Atenolol and Losartan in Marfan Syndrome. ( Dietz, HC; Forbus, GA; Gelb, BD; Goldmuntz, E; Hoskoppal, A; James, J; Lacro, RV; Lee, TM; Levine, JC; Li, JS; Loeys, BL; Markham, LW; Meester, JAN; Mital, S; Morris, SA; Mosley, JD; Olson, AK; Renard, M; Roden, DM; Shaffer, CM; Sharkey, A; Sleeper, LA; Van Driest, SL; Young, L, 2020)
"The aim of this study was to evaluate the effect of aliskiren on aortic stiffness in patients with Marfan syndrome (MS)."	5.27	Comparison of the Effect of Aliskiren Versus Negative Controls on Aortic Stiffness in Patients With Marfan Syndrome Under Treatment With Atenolol. ( Ahn, J; Carriere, K; Chang, SA; Choe, YH; Chung, TY; Hwang, JW; Jang, SY; Ki, CS; Kim, DK; Kim, EK; Kim, SM; Sung, K, 2018)
"The Pediatric Heart Network randomized trial of atenolol versus losartan in the Marfan syndrome showed no treatment differences in the rates of aortic-root growth or clinical outcomes."	5.27	Influence of Aortic Stiffness on Aortic-Root Growth Rate and Outcome in Patients With the Marfan Syndrome. ( Bradley, TJ; Campbell, MJ; Chen, S; Cohen, MS; Colan, SD; De Backer, J; Heydarian, H; Hoskoppal, A; Lacro, RV; Lai, WW; Levine, JC; Liou, A; Marcus, E; Nutting, A; Olson, AK; Parra, DA; Pearson, GD; Pierpont, ME; Printz, BF; Pyeritz, RE; Ravekes, W; Roman, MJ; Selamet Tierney, ES; Sharkey, AM; Sleeper, LA; Srivastava, S; Young, L, 2018)
"Long-term outcome of Marfan syndrome patients randomly assigned to losartan or atenolol showed no differences in aortic dilation rate or presence of clinical events between treatment groups."	5.27	Losartan Versus Atenolol for Prevention of Aortic Dilation in Patients With Marfan Syndrome. ( Evangelista, A; Forteza, A; García-Dorado, D; González Mirelis, J; Gutiérrez, L; Ibáñez, B; Rodríguez-Palomares, J; Sánchez, V; Teixido-Tura, G, 2018)
" atenolol in aortic dilation progression in Marfan syndrome (MFS) patients."	5.22	Efficacy of losartan vs. atenolol for the prevention of aortic dilation in Marfan syndrome: a randomized clinical trial. ( Centeno, J; Cortina, J; Evangelista, A; Ferreira-González, I; Forteza, A; García-Dorado, D; Gracia, T; Gutiérrez, L; Rodríguez-Palomares, J; Rufilanchas, JJ; Sánchez, V; Sanz, P; Teixidó-Turà, G, 2016)
"We conducted a randomized, double-blind trial of losartan (100 mg QD) versus atenolol (50 mg QD) for 6 months in adults with Marfan syndrome."	5.20	Distinct effects of losartan and atenolol on vascular stiffness in Marfan syndrome. ( Bhatt, AB; Buck, JS; Creager, MA; Gauvreau, K; Kadivar, S; Milian, J; Singh, MN; Zuflacht, JP, 2015)
"The Pediatric Heart Network designed a clinical trial to compare aortic root growth and other short-term cardiovascular outcomes in children and young adults with Marfan syndrome randomized to receive atenolol or losartan."	5.17	Characteristics of children and young adults with Marfan syndrome and aortic root dilation in a randomized trial comparing atenolol and losartan therapy. ( Benson, DW; Bradley, TJ; De Backer, J; Dietz, HC; Forbus, GA; Gelb, BD; Guey, LT; Klein, GL; Lacro, RV; Lai, WW; Levine, JC; Lewin, MB; Loeys, BL; Mahony, L; Markham, LW; Paridon, SM; Pearson, GD; Pierpont, ME; Radojewski, E; Selamet Tierney, ES; Sharkey, AM; Wechsler, SB; Yetman, AT, 2013)
"To assess the tolerability and efficacy of the investigational use of the angiotensin II receptor blocker losartan added to β-blockade (BB) to prevent progressive aortic root dilation in patients with Marfan syndrome (MFS)."	5.17	Losartan added to β-blockade therapy for aortic root dilation in Marfan syndrome: a randomized, open-label pilot study. ( Chen, CA; Chiu, HH; Chiu, SN; Hu, FC; Lin, MT; Lu, CW; Wang, JK; Wu, MH, 2013)
"The Pediatric Heart Network is conducting a large international randomized trial to compare aortic root growth and other cardiovascular outcomes in 608 subjects with Marfan syndrome randomized to receive atenolol or losartan for 3 years."	4.89	Echocardiographic methods, quality review, and measurement accuracy in a randomized multicenter clinical trial of Marfan syndrome. ( Bradley, TJ; Campbell, MJ; Chen, S; Cohen, MS; Colan, SD; De Backer, J; Guey, LT; Heydarian, H; Lacro, RV; Lai, WW; Levine, JC; Lewin, MB; Marcus, E; Mart, CR; Pearson, GD; Pignatelli, RH; Printz, BF; Selamet Tierney, ES; Sharkey, AM; Shirali, GS; Sleeper, LA; Srivastava, S, 2013)
"The Pediatric Heart Network Marfan Trial was a randomized trial comparing atenolol versus losartan on aortic root dilation in 608 children and young adults with Marfan syndrome."	3.96	Recruitment, retention, and adherence in a clinical trial: The Pediatric Heart Network's Marfan Trial experience. ( Atz, AM; Cappella, E; Cnota, JF; Dagincourt, N; De Nobele, S; Grima, J; Hamstra, MS; Hollenbeck-Pringle, D; King, M; Korsin, R; Lacro, RV; Lambert, LM; MacCarrick, G; MacNeal, MK; Markham, LW; Pemberton, VL; Sylvester, DM; Trachtenberg, FL; Walter, P; Xu, M, 2020)
" One of the twins suffered a type A aortic dissection, which required replacement of the ascending aorta, and the other twin had an aneurysmal dilatation of the ascending aorta (46mm) and was prescribed medical treatment with atenolol and periodic controls to detect the presence of a critical diameter (50mm) that would indicate the need for prophylactic surgery."	3.74	Monozygotic twins with Marfan's syndrome and ascending aortic aneurysm. ( Belforte, SM; Cianciulli, TF; Lax, JA; Picone, VP; Prezioso, HA; Recalde, B; Redruello, HJ; Rostello, EF, 2007)
"Beta-blockers, eg, atenolol, are the cornerstone therapy for thoracic aortic aneurysm (TAA) in patients with Marfan syndrome; however, continued aortic dilatation has been reported."	3.74	Long-term doxycycline is more effective than atenolol to prevent thoracic aortic aneurysm in marfan syndrome through the inhibition of matrix metalloproteinase-2 and -9. ( Chung, AW; Radomski, MW; van Breemen, C; Yang, HH, 2008)
"There was a heterogeneous response in the aortic root elastic properties after long-term treatment with atenolol in asymptomatic patients with Marfan syndrome."	3.70	Effect of long-term beta-blockade on aortic root compliance in patients with Marfan syndrome. ( Bavishi, N; Burton, BK; Clark, WA; Denes, P; Rios, AS; Silber, EN; Varga, P, 1999)
"The negative inotropic and chronotropic effects of beta-blocker therapy have been reported to reduce morbidity and mortality in patients with Marfan syndrome; however, little is known about the pharmacokinetics of atenolol after oral administration of multiple doses to patients with the Marfan syndrome."	3.69	Absorption pharmacokinetics of atenolol in patients with the Marfan syndrome. ( Alpert, BS; Lima, JJ; Phelps, SJ; Pieper, JA; Ward, JL, 1995)
"Efficacy of losartan versus atenolol in the prevention of progressive dilation of the aorta, improved aortic distensibility, and prevention of adverse events (aortic dissection or rupture, cardiovascular surgery, or death) will be assessed in this study."	2.76	[Study of the efficacy and safety of losartan versus atenolol for aortic dilation in patients with Marfan syndrome]. ( Centeno, J; Cortina, J; Evangelista, A; Forteza, A; García, D; García-Dorado, D; Gutiérrez, L; Rodríguez-Palomares, J; Sánchez, V; Sanz, P; Teixidó, G, 2011)
"The contribution of arrhythmias is unclear."	1.48	Frequency of Ventricular Arrhythmias and Other Rhythm Abnormalities in Children and Young Adults With the Marfan Syndrome. ( Crosson, JE; Czosek, RJ; Lacro, RV; Love, BA; Mah, DY; McCrindle, BW; Muiño-Mosquera, L; Olson, AK; Pilcher, TA; Shah, MJ; Sleeper, LA; Tierney, ESS; Wechsler, SB; Young, LT, 2018)

Research

Studies (39)

Authors

Clinical Trials (4)

Trial Overview

Trial Outcomes

Annual Rate of Change in Aortic Root (Sinuses of Valsalva) Absolute Dimension

Timeframe	Studies, this research(%)	All Research%
pre-1990	0 (0.00)	18.7374
1990's	4 (10.26)	18.2507
2000's	8 (20.51)	29.6817
2010's	23 (58.97)	24.3611
2020's	4 (10.26)	2.80

Authors	Studies
Robertson, DM	1
Truong, DT	1
Cox, DA	1
Carmichael, HL	1
Ou, Z	1
Minich, LL	2
Williams, RV	1
Selamet Tierney, ES	6
Van Driest, SL	1
Sleeper, LA	5
Gelb, BD	3
Morris, SA	1
Dietz, HC	5
Forbus, GA	2
Goldmuntz, E	1
Hoskoppal, A	2
James, J	1
Lee, TM	1
Levine, JC	6
Li, JS	2
Loeys, BL	3
Markham, LW	5
Meester, JAN	1
Mital, S	1
Mosley, JD	1
Olson, AK	5
Renard, M	1
Shaffer, CM	1
Sharkey, A	1
Young, L	2
Lacro, RV	10
Roden, DM	1
Hamstra, MS	2
Pemberton, VL	3
Dagincourt, N	1
Hollenbeck-Pringle, D	2
Trachtenberg, FL	2
Cnota, JF	1
Atz, AM	2
Cappella, E	2
De Nobele, S	2
Grima, J	1
King, M	1
Korsin, R	2
Lambert, LM	1
MacNeal, MK	1
MacCarrick, G	1
Sylvester, DM	1
Walter, P	1
Xu, M	2
Ayers, R	1
Kelleman, M	1
Iannucci, G	1
McCracken, C	1
Oster, ME	1
Hwang, JW	1
Kim, EK	1
Jang, SY	1
Chung, TY	1
Ki, CS	1
Sung, K	1
Kim, SM	1
Ahn, J	1
Carriere, K	1
Choe, YH	1
Chang, SA	1
Kim, DK	1
Roman, MJ	4
Bradley, TJ	6
Colan, SD	4
Chen, S	3
Campbell, MJ	2
Cohen, MS	2
De Backer, J	4
Heydarian, H	2
Lai, WW	4
Liou, A	3
Marcus, E	2
Nutting, A	1
Parra, DA	1
Pearson, GD	5
Pierpont, ME	3
Printz, BF	4
Pyeritz, RE	4
Ravekes, W	1
Sharkey, AM	4
Srivastava, S	2
Mah, DY	1
Crosson, JE	1
Czosek, RJ	1
Love, BA	1
McCrindle, BW	2
Muiño-Mosquera, L	1
Pilcher, TA	1
Tierney, ESS	1
Shah, MJ	1
Wechsler, SB	3
Young, LT	2
Teixido-Tura, G	3
Forteza, A	3
Rodríguez-Palomares, J	3
González Mirelis, J	1
Gutiérrez, L	3
Sánchez, V	3
Ibáñez, B	1
García-Dorado, D	3
Evangelista, A	4
Isselbacher, EM	1
Handisides, JC	1
Uzark, K	1
Atz, TW	1
Groh, GK	1
Lindauer, B	1
Neal, MKM	1
Morrison, T	1
Mussatto, KA	1
Pierpont, MEM	1
Radojewski, EA	1
Guey, LT	2
Lewin, MB	2
Mart, CR	1
Pignatelli, RH	1
Shirali, GS	1
Yetman, AT	3
Benson, DW	2
Klein, GL	3
Paridon, SM	3
Radojewski, E	3
Mahony, L	4
Bowen, JM	1
Connolly, HM	1
Braverman, AC	1
Grossfeld, PD	1
Stylianou, MP	2
Sandor, GG	1
Alghamdi, MH	1
Raffin, LA	1
Potts, MT	1
Williams, LD	1
Potts, JE	1
Kiess, M	1
van Breemen, C	2
Treasure, T	1
Pepper, J	1
Mohiaddin, R	1
Ziganshin, BA	1
Mukherjee, SK	1
Elefteriades, JA	1
Mallat, Z	1
Tedgui, A	1
Bhatt, AB	1
Buck, JS	1
Zuflacht, JP	1
Milian, J	1
Kadivar, S	1
Gauvreau, K	1
Singh, MN	1
Creager, MA	1
Lengellé, C	1
Bejan-Angoulvant, T	1
Beau-Salinas, F	1
Jonville-Béra, AP	1
Sanz, P	2
Gracia, T	1
Centeno, J	2
Rufilanchas, JJ	1
Cortina, J	2
Ferreira-González, I	1
O'Rourke, MF	1
Adji, A	1
Weber, T	1
Teixidó, G	1
García, D	1
Goya, M	1
Alvarez, M	1
Merced, C	1
Pineda, V	1
Williams, A	1
Kenny, D	1
Wilson, D	1
Fagenello, G	1
Nelson, M	1
Dunstan, F	1
Cockcroft, J	1
Stuart, G	1
Fraser, AG	1
Chiu, HH	1
Wu, MH	1
Wang, JK	1
Lu, CW	1
Chiu, SN	1
Chen, CA	1
Lin, MT	1
Hu, FC	1
Meijboom, LJ	1
Westerhof, BE	1
Nollen, GJ	1
Spaan, JA	2
de Mol, BA	1
Jacobs, MJ	1
Mulder, BJ	2
Bornemeier, RA	1
Redruello, HJ	1
Cianciulli, TF	1
Rostello, EF	1
Recalde, B	1
Lax, JA	1
Picone, VP	1
Belforte, SM	1
Prezioso, HA	1
Jondeau, G	1
Barthelet, M	1
Baumann, C	1
Bonnet, D	1
Chevallier, B	1
Collignon, P	1
Dulac, Y	1
Edouard, T	1
Faivre, L	1
Germain, D	1
Khau Van Kien, P	1
Lacombe, D	1
Ladouceur, M	1
Lemerrer, M	1
Leheup, B	1
Lupoglazoff, JM	1
Magnier, S	1
Muti, C	1
Plauchu, PH	1
Raffestin, B	1
Sassolas, F	1
Schleich, JM	1
Sidi, D	1
Themar-Noël, C	1
Varin, J	1
Wolf, JE	1
Baumgartner, D	1
Baumgartner, C	1
Schermer, E	1
Engl, G	1
Schweigmann, U	1
Mátyás, G	1
Steinmann, B	1
Stein, JI	1
Feingold, B	1
Park, SC	1
Graham, D	1
Kleinman, CS	1
Mahnke, CB	1
Timchak, DM	1
Neches, WH	1
Gersony, WM	1
Wruck, LM	1
Devereux, RB	1
Saul, JP	1
Chung, AW	1
Yang, HH	1
Radomski, MW	1
Phelps, SJ	1
Alpert, BS	2
Ward, JL	1
Pieper, JA	1
Lima, JJ	1
Reed, CM	1
Fox, ME	1
Groenink, M	1
de Roos, A	1
van der Wall, EE	1
Rios, AS	1
Silber, EN	1
Bavishi, N	1
Varga, P	1
Burton, BK	1
Clark, WA	1
Denes, P	1

Trial	Phase	Enrollment	Study Type	Start Date	Status
Trial of Beta Blocker Therapy (Atenolol) Versus Angiotensin II Receptor Blocker Therapy (Losartan) in Individuals With Marfan Syndrome (A Trial Conducted by the Pediatric Heart Network)[NCT00429364]	Phase 3	608 participants (Actual)	Interventional	2007-01-31	Completed
A Randomized Double-blind Study Assessing the Effects of Losartan Versus Atenolol on Pulse Wave Velocity and the Biophysical Properties of the Aorta in Patients With Marfan Syndrome[NCT00593710]	Phase 2	17 participants (Actual)	Interventional	2008-01-31	Completed
A Randomized, Open-label, Active Control Trial to Evaluate the Effect of LOSARTAN Therapy on the Progression of Aortic Root Dilation in Patients With Marfan Syndrome[NCT00651235]	Phase 2	44 participants (Anticipated)	Interventional	2007-02-28	Recruiting
Effects of Losartan vs. Nebivolol vs. the Association of Both on the Progression of Aortic Root Dilation in Marfan Syndrome (MFS) With FBN1 Gene Mutations.[NCT00683124]	Phase 3	291 participants (Anticipated)	Interventional	2008-07-31	Recruiting
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

The rate of change in the absolute dimension of the aortic root over a 3-year period following randomization (NCT00429364)
Timeframe: Up to 3 years following randomization.

Annual Rate of Change in Aortic Root (Sinuses of Valsalva) Body-surface-area-adjusted Z-score

Intervention	cm/year (Least Squares Mean)
Atenolol	0.069
Losartan	0.075

The rate of aortic root enlargement, expressed as the annual change in the maximum aortic-root-diameter z score indexed to body-surface area over a 3-year period following randomization (NCT00429364)
Timeframe: Up to 3 years following randomization.

Annual Rate of Change in Aortic-annulus-diameter Z Score, Adjusted by Body-surface Area

Annual Rate of Change in Arm Span to Height Ratio

Annual Rate of Change in Ascending-aorta-diameter Z Score, Adjusted by Body-surface-area.

Annual Rate of Change in Body Mass Index

Annual Rate of Change in Body Mass Index for Age Z-score

Annual Rate of Change in Height

Annual Rate of Change in Height-for-age Z-score

Annual Rate of Change in the Absolute Diameter of the Aortic Annulus

Annual Rate of Change in the Absolute Diameter of the Ascending Aorta

Annual Rate of Change in Total Aortic Proximal Regurgitant Jet Area Indexed to Body-surface-area

Annual Rate of Change in Upper to Lower Segment Ratio

Annual Rate of Change in Weight

Annual Rate of Change in Weight-for-age Z-score

Annual Rate of Change in Weight-for-height Z-score

Event Rate of Aortic Dissection.

Intervention	z-score/year (Least Squares Mean)
Atenolol	-0.139
Losartan	-0.107

Intervention	z-score/year (Least Squares Mean)
Atenolol	-0.279
Losartan	-0.175

Intervention	1/year (Least Squares Mean)
Atenolol	0.001
Losartan	0.001

Intervention	z-score/year (Least Squares Mean)
Atenolol	-0.140
Losartan	-0.114

Intervention	kg/m^2 per year (Least Squares Mean)
Atenolol	0.063
Losartan	0.076

Intervention	z-score/year (Least Squares Mean)
Atenolol	0.007
Losartan	0.021

Intervention	cm/year (Least Squares Mean)
Atenolol	0.822
Losartan	0.935

Intervention	z-score/year (Least Squares Mean)
Atenolol	0.046
Losartan	0.019

Intervention	cm/year (Least Squares Mean)
Atenolol	0.015
Losartan	0.030

Intervention	cm/year (Least Squares Mean)
Atenolol	0.039
Losartan	0.044

Intervention	(mm^2/m^2)/year (Least Squares Mean)
Atenolol	0.005
Losartan	0.001

Intervention	1/year (Least Squares Mean)
Atenolol	-0.014
Losartan	-0.015

Intervention	kg/year (Least Squares Mean)
Atenolol	0.239
Losartan	0.229

Intervention	z-score/year (Least Squares Mean)
Atenolol	0.011
Losartan	0.019

Intervention	z-score/year (Least Squares Mean)
Atenolol	-0.001
Losartan	-0.157

Percentage of participants who had aortic dissection over a 3-year period following randomization. (NCT00429364)
Timeframe: Up to 3 years following randomization.

Event Rate of Aortic-Root Surgery

Intervention	Percentage of participants (Number)
Atenolol	0
Losartan	0.7

Percentage of participants who had aortic-root surgery over a 3-year period following randomization. (NCT00429364)
Timeframe: Up to 3 years following randomization.

Event Rate of Death

Intervention	Percentage of participants (Number)
Atenolol	3.4
Losartan	6.0

Percentage of participants who died over a 3-year period following randomization. (NCT00429364)
Timeframe: Up to 3 years following randomization.

Event Rate of the Composite Adverse Clinical Outcomes, Including Aortic Dissection, Aortic-root Surgery and Death.

Intervention	Percentage of participants (Number)
Atenolol	0
Losartan	0.3

Percentage of participants who had aortic dissection, aortic-root surgery or death over a 3-year period following randomization (NCT00429364)
Timeframe: Up to 3 years following randomization.

Intervention	participants (Number)
	Headache, any severity	Headache, bothersome	Fatigue, any severity	Fatigue, bothersome	Mood alterations, any severity	Mood alterations, bothersome	Behavior changes, any severity	Behavior changes, bothersome	Insomnia, any severity	Insomnia, bothersome	Nightmares, any severity	Nightmares, bothersome	Dizziness with standing, any severity	Dizziness with standing, bothersome	Dizziness - other, any severity	Dizziness - other, bothersome	Fainting with loss of consciousness, any severity	Fainting with loss of consciousness, bothersome	Palpitations, any severity	Palpitations, bothersome	Chest pain, any severity	Chest pain, bothersome	Dyspnea, any severity	Dyspnea, bothersome	Wheezing, any severity	Wheezing, bothersome	Upper respiratory/Nasal congestion, any severity	Upper respiratory/Nasal congestion, bothersome	Cough, any severity	Cough, bothersome	Dysgeusia, any severity	Dysgeusia, bothersome	Stomach pain/Indigestion, any severity	Stomach pain/Indigestion, bothersome	Nausea, any severity	Nausea, bothersome	Vomiting, any severity	Vomiting, bothersome	Diarrhea, any severity	Diarrhea, bothersome	Constipation, any severity	Constipation, bothersome	Vascular (hands, feet), any severity	Vascular (hands, feet), bothersome	Muscle pain or Cramps, any severity	Muscle pain or Cramps, bothersome	Back pain, any severity	Back pain, bothersome	Periorbital edema, any severity	Periorbital edema, bothersome	Pedal edema, any severity	Pedal edema, bothersome	Other, any severity	Other, bothersome
Atenolol	112	10	84	0	54	7	21	2	60	2	52	2	60	0	25	0	5	5	60	0	54	1	43	3	15	2	106	0	47	1	10	0	47	0	30	1	23	0	35	1	44	0	35	0	59	2	60	3	13	0	2	0	21	3
Losartan	114	10	105	0	49	3	23	1	61	2	53	3	58	2	27	1	9	9	53	0	58	5	38	0	14	1	117	2	59	0	3	0	61	1	35	0	23	0	43	1	35	0	34	1	58	4	67	2	15	0	3	0	16	1

Intervention	participants (Number)
	Headache, any severity	Headache, bothersome	Fatigue, any severity	Fatigue, bothersome	Mood alterations, any severity	Mood alterations, bothersome	Behavior changes, any severity	Behavior changes, bothersome	Insomnia, any severity	Insomnia, bothersome	Nightmares, any severity	Nightmares, bothersome	Dizziness with standing, any severity	Dizziness with standing, bothersome	Dizziness - other, any severity	Dizziness - other, bothersome	Fainting with loss of consciousness, any severity	Fainting with loss of consciousness, bothersome	Palpitations, any severity	Palpitations, bothersome	Chest pain, any severity	Chest pain, bothersome	Dyspnea, any severity	Dyspnea, bothersome	Wheezing, any severity	Wheezing, bothersome	Upper respiratory/Nasal congestion, any severity	Upper respiratory/Nasal congestion, bothersome	Cough, any severity	Cough, bothersome	Dysgeusia, any severity	Dysgeusia, bothersome	Stomach pain/Indigestion, any severity	Stomach pain/Indigestion, bothersome	Nausea, any severity	Nausea, bothersome	Vomiting, any severity	Vomiting, bothersome	Diarrhea, any severity	Diarrhea, bothersome	Constipation, any severity	Constipation, bothersome	Vascular (hands, feet), any severity	Vascular (hands, feet), bothersome	Muscle pain or Cramps, any severity	Muscle pain or Cramps, bothersome	Back pain, any severity	Back pain, bothersome	Periorbital edema, any severity	Periorbital edema, bothersome	Pedal edema, any severity	Pedal edema, bothersome	Other, any severity	Other, bothersome
Atenolol	202	27	152	7	89	13	51	5	108	6	100	7	119	6	60	2	21	21	86	0	114	14	75	1	36	2	188	3	117	1	29	0	119	2	99	0	81	1	94	1	77	1	73	0	148	6	137	5	22	0	6	0	105	10
Losartan	208	20	153	5	86	13	46	8	107	4	94	4	105	0	61	0	16	16	101	0	106	1	72	3	32	5	186	3	113	1	16	0	121	8	78	0	75	2	90	3	66	0	66	0	124	7	134	8	27	1	5	0	108	12

Article	Year
Pediatric Heart Network Trial of Losartan vs. Atenolol in Children and Young Adults with Marfan Syndrome: Impact on Prescription Practices. Pediatric cardiology, 2023, Volume: 44, Issue:3 Topics: Adolescent; Adrenergic beta-Antagonists; Adult; Angiotensin II Type 1 Receptor Blockers; Angiotensin	2023
Variants in ADRB1 and CYP2C9: Association with Response to Atenolol and Losartan in Marfan Syndrome. The Journal of pediatrics, 2020, Volume: 222 Topics: Adolescent; Adrenergic beta-1 Receptor Antagonists; Adult; Angiotensin II Type 1 Receptor Blockers;	2020
Comparison of the Effect of Aliskiren Versus Negative Controls on Aortic Stiffness in Patients With Marfan Syndrome Under Treatment With Atenolol. Revista espanola de cardiologia (English ed.), 2018, Volume: 71, Issue:9 Topics: Adrenergic beta-1 Receptor Antagonists; Adult; Amides; Aorta, Thoracic; Atenolol; Blood Pressure; Do	2018
Influence of Aortic Stiffness on Aortic-Root Growth Rate and Outcome in Patients With the Marfan Syndrome. The American journal of cardiology, 2018, 05-01, Volume: 121, Issue:9 Topics: Adolescent; Aorta; Aortic Diseases; Atenolol; Cardiac Imaging Techniques; Child; Child, Preschool; D	2018
Losartan Versus Atenolol for Prevention of Aortic Dilation in Patients With Marfan Syndrome. Journal of the American College of Cardiology, 2018, 10-02, Volume: 72, Issue:14 Topics: Adrenergic beta-1 Receptor Antagonists; Adult; Angiotensin II Type 1 Receptor Blockers; Aorta; Aorti	2018
Health-Related Quality of Life in Children and Young Adults with Marfan Syndrome. The Journal of pediatrics, 2019, Volume: 204 Topics: Adolescent; Adult; Antihypertensive Agents; Atenolol; Child; Child, Preschool; Female; Health Status	2019
Characteristics of children and young adults with Marfan syndrome and aortic root dilation in a randomized trial comparing atenolol and losartan therapy. American heart journal, 2013, Volume: 165, Issue:5 Topics: Adolescent; Adrenergic beta-1 Receptor Antagonists; Adult; Angiotensin II Type 1 Receptor Blockers;	2013
Atenolol versus losartan in children and young adults with Marfan's syndrome. The New England journal of medicine, 2014, Nov-27, Volume: 371, Issue:22 Topics: Adrenergic beta-Antagonists; Adult; Angiotensin II Type 1 Receptor Blockers; Aorta; Aortic Aneurysm;	2014
A randomized, double blind pilot study to assess the effects of losartan vs. atenolol on the biophysical properties of the aorta in patients with Marfan and Loeys-Dietz syndromes. International journal of cardiology, 2015, Jan-20, Volume: 179 Topics: Adolescent; Adrenergic beta-1 Receptor Antagonists; Angiotensin II Type 1 Receptor Blockers; Aorta;	2015
Distinct effects of losartan and atenolol on vascular stiffness in Marfan syndrome. Vascular medicine (London, England), 2015, Volume: 20, Issue:4 Topics: Adrenergic beta-1 Receptor Antagonists; Adult; Angiotensin II Type 1 Receptor Blockers; Aortic Aneur	2015
Efficacy of losartan vs. atenolol for the prevention of aortic dilation in Marfan syndrome: a randomized clinical trial. European heart journal, 2016, Mar-21, Volume: 37, Issue:12 Topics: Adolescent; Adult; Angiotensin II Type 1 Receptor Blockers; Aorta; Aortic Aneurysm; Atenolol; Child;	2016
[Study of the efficacy and safety of losartan versus atenolol for aortic dilation in patients with Marfan syndrome]. Revista espanola de cardiologia, 2011, Volume: 64, Issue:6 Topics: Adolescent; Adult; Antihypertensive Agents; Aorta; Aortic Diseases; Atenolol; Child; Child, Preschoo	2011
Effects of atenolol, perindopril and verapamil on haemodynamic and vascular function in Marfan syndrome - a randomised, double-blind, crossover trial. European journal of clinical investigation, 2012, Volume: 42, Issue:8 Topics: Adolescent; Adult; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Atenolol; Bloo	2012
Losartan added to β-blockade therapy for aortic root dilation in Marfan syndrome: a randomized, open-label pilot study. Mayo Clinic proceedings, 2013, Volume: 88, Issue:3 Topics: Adolescent; Adrenergic beta-1 Receptor Antagonists; Angiotensin II Type 1 Receptor Blockers; Aortic	2013
Usefulness of enalapril versus propranolol or atenolol for prevention of aortic dilation in patients with the Marfan syndrome. The American journal of cardiology, 2005, May-01, Volume: 95, Issue:9 Topics: Adolescent; Adrenergic beta-Antagonists; Angiotensin-Converting Enzyme Inhibitors; Aorta; Atenolol;	2005
Rationale and design of a randomized clinical trial of beta-blocker therapy (atenolol) versus angiotensin II receptor blocker therapy (losartan) in individuals with Marfan syndrome. American heart journal, 2007, Volume: 154, Issue:4 Topics: Adrenergic beta-Antagonists; Adult; Angiotensin II Type 1 Receptor Blockers; Atenolol; Humans; Losar	2007

Article	Year
Recruitment, retention, and adherence in a clinical trial: The Pediatric Heart Network's Marfan Trial experience. Clinical trials (London, England), 2020, Volume: 17, Issue:6 Topics: Adolescent; Anti-Arrhythmia Agents; Atenolol; Black or African American; Child; Child, Preschool; Cl	2020
Racial and ethnic differences in response to treatment for Marfan syndrome. Cardiology in the young, 2021, Volume: 31, Issue:12 Topics: Angiotensin II Type 1 Receptor Blockers; Aorta; Atenolol; Child; Humans; Losartan; Marfan Syndrome;	2021
Frequency of Ventricular Arrhythmias and Other Rhythm Abnormalities in Children and Young Adults With the Marfan Syndrome. The American journal of cardiology, 2018, 10-15, Volume: 122, Issue:8 Topics: Adolescent; Adrenergic beta-Antagonists; Adult; Angiotensin II Type 1 Receptor Blockers; Arrhythmias	2018
Losartan for the Treatment of Marfan Syndrome: Hope Fades. Journal of the American College of Cardiology, 2018, 10-02, Volume: 72, Issue:14 Topics: Angiotensin II Type 1 Receptor Blockers; Atenolol; Dilatation; Humans; Losartan; Marfan Syndrome	2018
Of Marfan's syndrome, mice, and medications. The New England journal of medicine, 2014, Nov-27, Volume: 371, Issue:22 Topics: Adrenergic beta-Antagonists; Angiotensin II Type 1 Receptor Blockers; Aorta; Aortic Aneurysm; Atenol	2014
Atenolol versus Losartan in Marfan's Syndrome. The New England journal of medicine, 2015, 03-05, Volume: 372, Issue:10 Topics: Adrenergic beta-Antagonists; Angiotensin II Type 1 Receptor Blockers; Aorta; Aortic Aneurysm; Atenol	2015
Atenolol versus Losartan in Marfan's Syndrome. The New England journal of medicine, 2015, 03-05, Volume: 372, Issue:10 Topics: Adrenergic beta-Antagonists; Angiotensin II Type 1 Receptor Blockers; Aorta; Aortic Aneurysm; Atenol	2015
Atenolol versus Losartan in Marfan's Syndrome. The New England journal of medicine, 2015, 03-05, Volume: 372, Issue:10 Topics: Adrenergic beta-Antagonists; Angiotensin II Type 1 Receptor Blockers; Aorta; Aortic Aneurysm; Atenol	2015
Atenolol versus Losartan in Marfan's Syndrome. The New England journal of medicine, 2015, 03-05, Volume: 372, Issue:10 Topics: Adrenergic beta-Antagonists; Angiotensin II Type 1 Receptor Blockers; Aorta; Aortic Aneurysm; Atenol	2015
[Drugs news]. Archives de pediatrie : organe officiel de la Societe francaise de pediatrie, 2015, Volume: 22, Issue:11 Topics: Adrenergic beta-Antagonists; Angiotensin II Type 1 Receptor Blockers; Anti-Obesity Agents; Anticonvu	2015
Correspondence regarding: Distinct effects of losartan and atenolol on vascular stiffness in Marfan syndrome by Bhatt et al. Vascular medicine (London, England), 2016, Volume: 21, Issue:1 Topics: Adrenergic beta-1 Receptor Antagonists; Angiotensin II Type 1 Receptor Blockers; Aortic Aneurysm; At	2016
Abdominal aortic dilatation during pregnancy in Marfan syndrome. Revista espanola de cardiologia (English ed.), 2012, Volume: 65, Issue:3 Topics: Adrenergic beta-Antagonists; Adult; Aorta, Abdominal; Aorta, Thoracic; Aortic Diseases; Atenolol; Ce	2012
Beta-blocking therapy in patients with the Marfan syndrome and entire aortic replacement. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2004, Volume: 26, Issue:5 Topics: Adrenergic beta-Antagonists; Adult; Aorta; Atenolol; Blood Pressure; Blood Vessel Prosthesis Implant	2004
Monozygotic twins with Marfan's syndrome and ascending aortic aneurysm. European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology, 2007, Volume: 8, Issue:4 Topics: Adult; Aorta; Aortic Aneurysm; Aortic Dissection; Atenolol; Humans; Male; Marfan Syndrome; Twins, Mo	2007
[Recommendations for the medical management of aortic complications of Marfan's syndrome]. Archives des maladies du coeur et des vaisseaux, 2006, Volume: 99, Issue:5 Topics: Adrenergic beta-Antagonists; Aortic Aneurysm; Aortic Dissection; Atenolol; Bisoprolol; Calcium Chann	2006
Different patterns of aortic wall elasticity in patients with Marfan syndrome: a noninvasive follow-up study. The Journal of thoracic and cardiovascular surgery, 2006, Volume: 132, Issue:4 Topics: Adolescent; Adrenergic beta-Antagonists; Adult; Aorta, Thoracic; Atenolol; Child; Child, Preschool;	2006
Beta-blocker therapy does not alter the rate of aortic root dilation in pediatric patients with Marfan syndrome. The Journal of pediatrics, 2007, Volume: 150, Issue:1 Topics: Adolescent; Adrenergic beta-Antagonists; Aorta, Thoracic; Atenolol; Child; Dilatation, Pathologic; D	2007
Long-term doxycycline is more effective than atenolol to prevent thoracic aortic aneurysm in marfan syndrome through the inhibition of matrix metalloproteinase-2 and -9. Circulation research, 2008, Apr-25, Volume: 102, Issue:8 Topics: Adrenergic beta-Antagonists; Animals; Aortic Aneurysm, Thoracic; Atenolol; Disease Models, Animal; D	2008
Absorption pharmacokinetics of atenolol in patients with the Marfan syndrome. Journal of clinical pharmacology, 1995, Volume: 35, Issue:3 Topics: Absorption; Administration, Oral; Adolescent; Adult; Atenolol; Drug Administration Schedule; Exercis	1995
Aortic biomechanical properties in pediatric patients with the Marfan syndrome, and the effects of atenolol. The American journal of cardiology, 1993, Mar-01, Volume: 71, Issue:7 Topics: Adolescent; Adult; Aorta; Atenolol; Biomechanical Phenomena; Child; Echocardiography; Elasticity; Fe	1993
Changes in aortic distensibility and pulse wave velocity assessed with magnetic resonance imaging following beta-blocker therapy in the Marfan syndrome. The American journal of cardiology, 1998, Jul-15, Volume: 82, Issue:2 Topics: Adolescent; Adrenergic beta-Antagonists; Adult; Age Factors; Aorta; Atenolol; Blood Pressure; Case-C	1998
Effect of long-term beta-blockade on aortic root compliance in patients with Marfan syndrome. American heart journal, 1999, Volume: 137, Issue:6 Topics: Adrenergic beta-Antagonists; Adult; Aorta; Aortic Valve; Atenolol; Chi-Square Distribution; Complian	1999

atenolol and Marfan Syndrome