Evidence map›Paper›PMID 34475413›Full record

ReviewNature reviews. Disease primers2021

Marfan syndrome.

Dianna M Milewicz, Alan C Braverman, Julie De Backer, Shaine A Morris, Catherine Boileau, Irene H Maumenee, Guillaume Jondeau, Arturo Evangelista, Reed E Pyeritz

Erratum issued Registry-linked trialOpen access · bronzeAbstract readReview
In one paragraph

Review in Nature reviews. Disease primers, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT07495267 (Nutritional Ketosis as a Novel Therapeutic Strategy to Stabilize Chronic Aortic Dissection in Marfan Syndrome), which is not on this map. Cited by 170 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
170citing papers in PubMed, 1 pooled it
31.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07495267 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Nutritional Ketosis as a Novel Therapeutic Strategy to Stabilize Chronic Aortic Dissection in Marfan Syndrome

TypeinterventionalSponsorWashington University School of MedicineRan2026 to 2028Enrolled15ConditionsMarfan Syndrome, Aortic DissectionArmsKetogenic diet
3 · Its place in the literature

Who cites it

170 citing papers in PubMed, 1 synthesis or guideline pooled it, 266 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
  9. Review
  10. Article
  11. Lymphatic therapies open the valve in Marfan syndrome.The Journal of clinical investigation · 2026
    Article
  12. Hypertension drives thoracic aortic aneurysm and dissection in male, but not female, Marfan mice.Journal of the mechanical behavior of biomedical materials · 2026
    Article
  13. Article
  14. Article
  15. Growth arrest of thoracic aortic aneurysms in aging Marfan mice.American journal of physiology. Heart and circulatory physiology · 2026
    Article
  16. Article
  17. Article
  18. Angiotensin II Induces Abdominal Aortic Branch Aneurysms inArteriosclerosis, thrombosis, and vascular biology · 2026
    Article
  19. Article
  20. Article

110 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 8 institutions in 4 countries.

Dianna M MilewiczDivision of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA. Dianna.M.Milewicz@uth.tmc.edu.ORCID http://orcid.org/0000-0002-7806-0068
Alan C BravermanCardiovascular Division, Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
Julie De BackerDepartment of Paediatric Cardiology and Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium.
Shaine A MorrisDivision of Paediatric Cardiology, Department of Paediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.ORCID http://orcid.org/0000-0002-8056-0934
Catherine BoileauAPHP Hôpital Bichat-Claude Bernard, Département de Génétique, Université de Paris, INSERM U1148, LVTS, Paris, France.ORCID http://orcid.org/0000-0002-0371-7539
Irene H MaumeneeDepartment of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, New York, NY, USA.ORCID http://orcid.org/0000-0003-0036-6208
Guillaume JondeauAPHP, National Reference Center for Marfan syndrome and related disorders, Hôpital Bichat-Claude Bernard, Paris, France.
Arturo EvangelistaServei de Cardiologia, Hospital Vall d´Hebron-VHIR, CIBER-CV, Instituto Cardiólogico, Quironsalud-Teknon, Barcelona, Spain.
Reed E PyeritzDivision of Translational Medicine and Human Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Université Claude Bernard Lyon 1 · FRBaylor College of Medicine · USColumbia University · USGhent University Hospital · BEHospital Quirón Teknon · ESThe University of Texas Health Science Center · USUniversity of Pennsylvania · USWashington University in St. Louis · US

Funding

Genetic Predisposition To Thoracic Aortic Aneurysms/DissectionsR01HL109942 · NHLBI · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI MILEWICZ, DIANNA M · 2012 to 2023
$7.5M
Novel genetic Insight into the molecular pathogenesis of atherosclerosisR01HL146583 · NHLBI · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI MILEWICZ, DIANNA M · 2019 to 2022
$2.6M
NHLBI NIH HHS R01 HL109942NHLBI NIH HHS R01 HL146583
6 · The paper itself

Abstract

Marfan syndrome (MFS) is an autosomal dominant, age-related but highly penetrant condition with substantial intrafamilial and interfamilial variability. MFS is caused by pathogenetic variants in FBN1, which encodes fibrillin-1, a major structural component of the extracellular matrix that provides support to connective tissues, particularly in arteries, the pericondrium and structures in the eye. Up to 25% of individuals with MFS have de novo variants. The most prominent manifestations of MFS are asymptomatic aortic root aneurysms, aortic dissections, dislocation of the ocular lens (ectopia lentis) and skeletal abnormalities that are characterized by overgrowth of the long bones. MFS is diagnosed based on the Ghent II nosology; genetic testing confirming the presence of a FBN1 pathogenetic variant is not always required for diagnosis but can help distinguish MFS from other heritable thoracic aortic disease syndromes that can present with skeletal features similar to those in MFS. Untreated aortic root aneurysms can progress to life-threatening acute aortic dissections. Management of MFS requires medical therapy to slow the rate of growth of aneurysms and decrease the risk of dissection. Routine surveillance with imaging techniques such as transthoracic echocardiography, CT or MRI is necessary to monitor aneurysm growth and determine when to perform prophylactic repair surgery to prevent an acute aortic dissection.

Indexed as

Marfan SyndromeFibrillin-1FibrillinsHumansMicrofilament ProteinsMutationFibrillin-1FibrillinsMicrofilament Proteins

Identifiers

PMID34475413
PMCPMC9261969
OpenAlexW4205844844

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.