Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC, USA.
Division of Cardiothoracic Surgery, Medical University of South Carolina and Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA.
Adv Exp Med Biol. 2021;1348:185-206. doi: 10.1007/978-3-030-80614-9_8.
Marfan syndrome (MFS) is a systemic connective tissue disorder that is inherited in an autosomal dominant pattern with variable penetrance. While clinically this disease manifests in many different ways, the most life-threatening manifestations are related to cardiovascular complications including mitral valve prolapse, aortic insufficiency, dilatation of the aortic root, and aortic dissection. In the past 30 years, research efforts have not only identified the genetic locus responsible but have begun to elucidate the molecular pathogenesis underlying this disorder, allowing for the development of seemingly rational therapeutic strategies for treating affected individuals. In spite of these advancements, the cardiovascular complications still remain as the most life-threatening clinical manifestations. The present chapter will focus on the pathophysiology and clinical treatment of Marfan syndrome, providing an updated overview of the recent advancements in molecular genetics research and clinical trials, with an emphasis on how this information can focus future efforts toward finding betters ways to detect, diagnose, and treat this devastating condition.
马凡综合征(MFS)是一种系统性结缔组织疾病,呈常染色体显性遗传,具有可变的外显率。虽然临床上这种疾病有多种不同的表现,但最危及生命的表现与心血管并发症有关,包括二尖瓣脱垂、主动脉瓣关闭不全、主动脉根部扩张和主动脉夹层。在过去的 30 年中,研究工作不仅确定了负责的遗传位置,而且开始阐明这种疾病的分子发病机制,为治疗受影响个体的看似合理的治疗策略的发展提供了依据。尽管取得了这些进展,但心血管并发症仍然是最危及生命的临床表现。本章将重点介绍马凡综合征的病理生理学和临床治疗,提供分子遗传学研究和临床试验的最新进展概述,重点介绍如何利用这些信息为寻找更好的方法来检测、诊断和治疗这种毁灭性疾病提供依据。