Abstract
BACKGROUND AND AIMS: Marfan Syndrome (MFS) is a hereditary connective tissue disorder with severe cardiovascular complications, including aortic aneurysms and dissections. Current therapies, such as beta-blockers, have limitations in preventing disease progression. Angiotensin receptor blockers (ARBs) have emerged as a potential therapy due to their modulation of the renin-angiotensin-aldosterone system. This review evaluates the evidence of ARBs' cardiovascular benefits in MFS, focusing on their effects on aortic root dilation, stiffness, and clinical outcomes. METHODS: A review of literature published between January 2000 and June 2024 was conducted using databases like PubMed, Scopus, Web of Science, and Cochrane Library. Search terms included "Marfan Syndrome," "Angiotensin Receptor Blockers," and "cardiovascular outcomes." Studies assessing the efficacy and safety of ARBs in MFS were included, with their findings summarized descriptively. RESULTS: Preclinical studies demonstrated ARBs' effectiveness in reducing aortic root dilation and stiffness in murine models of MFS. Clinical trials highlighted losartan's ability to slow aortic root dilation in adults and children, with synergistic effects when combined with beta-blockers. Despite promising results, variability in study designs and dosage regimens limited comparability. A systematic review noted significant TGF-β inhibition-related improvements in pediatric patients. However, long-term safety and optimal dosing require further exploration. CONCLUSION: ARBs show promise in mitigating cardiovascular complications in MFS by reducing aortic root dilation and improving vascular function. Further research is essential to determine optimal dosing, long-term efficacy, and combination therapy potential, paving the way for personalized management strategies to improve patient outcomes.