Pulse wave reflections and their diurnal changes in patients with Marfan syndrome compared to healthy controls

Introduction: Patients with Marfan syndrome may suffer from a variety of symptoms, including changes of the cardiovascular system. The aim of this study was to perform ambulatory 24 hour blood pressure and pulse wave measurements in a group of Marfan patients and a group of healthy controls and to analyse wave reflections. Methods: All measurements were obtained with the Mobil-O-Graph device. Reflection magnitude (RM) was calculated with the inbuilt ARCSolver algorithms and averaged during daytime and nighttime. The study included 27 patients with Marfan syndrome and 27 healthy controls. Matching criteria were age (39 years mean in both groups), sex (14 female) and daytime brachial systolic blood pressure (119 mmHg mean in both groups). Patients with Marfan syndrome were significantly taller than controls (190 cm vs. 174 cm). Results: Reflection magnitude increased significantly during night in both groups (Marfan: 57.8 day, 66.6 night; controls: 58.6 day, 68.7 night). Differences between groups were not significant both day and night. Correlations between RM and body height were positive in Marfan patients (R=0.36 day, R=0.33 night) but negative in controls (R=−0.47 day, R=−0.66 night), showing a significantly different trend (p<0.01). Conclusions: There are similar levels and diurnal changes of reflection magnitude in patients with Marfan syndrome and healthy controls, but correlations of RM to body height are significantly different in Marfans and controls. This finding may relate to structural changes of the cardiovascular system associated with Marfan syndrome.