Aortic & peripheral vascular diseaseCohort study

Differences in Arterial Events in Vascular Ehlers-Danlos, Loeys-Dietz, and Marfan Syndrome

J Am Coll CardiolPublished

  • Retrospective cohort study
  • multicentre consortium (Montalcino Aortic Consortium)

Authors' conclusion

There are significant gene- and sex-specific differences in the prevalence and age of onset of arterial events associated with these heritable thoracic aortic disease genes, highlighting the importance of tailored counseling and surveillance based on the causative gene.

Study context

Population
Individuals with pathogenic variants in heritable thoracic aortic disease genes (COL3A1, FBN1, transforming growth factor (TGF)-β pathway genes)
Participants
1,780 individuals
Exposure
Arterial and aortic events by causative gene: COL3A1 vs TGF-β pathway genes vs FBN1
  • COL3A1n = 125
  • TGFBR2n = 168
  • TGFBR1n = 137
  • TGFB2n = 126
  • SMAD3n = 196
  • FBN1n = 1,028
Outcome
Arterial events (dissection, rupture or aneurysm of arteries beyond the aorta requiring open or endovascular repair); aortic events (aortic dissection or aortic aneurysm repair)

Main finding

As reported in the abstract

Prevalence of arterial events (83 individuals overall)

Observational data: associations, not effects.

Further findings

Aortic vs arterial events

TGF-β genes and FBN1: aortic events significantly earlier and more penetrant than arterial events; no such difference with COL3A1

Arterial events by sex

Males with COL3A1 had earlier and more arterial events vs males with TGF-β genes; not observed in females
Arterial events in FBN1 occur primarily in men

Original publication

Differences in Arterial Events in Vascular Ehlers-Danlos, Loeys-Dietz, and Marfan Syndrome. J Am Coll Cardiol. Published 24 June 2025. doi:10.1016/j.jacc.2025.04.023

Summarised from the published abstract; every number is checked against it