LDS Guidelines: Then vs. Now 50:21-52:43 Do you want to say anything about this or this is a kind of an outline, you know, when we look at Loeys-Dietz syndrome compared to Marfan syndrome, compared to Shprintzen-Goldberg syndrome, which Dr…

LDS Guidelines: Then vs. Now 46:57-50:15 Same thing for gastroenterology and nutrition for Loeys-Dietz syndrome. We do follow the growth of our patients, especially our young kiddos very closely, especially if someone is looking at a surge…

LDS Guidelines: Then vs. Now 44:57-46:54 So I know Tony is taking notes for us, Dr. Guerrerio and if he has anything to jump in but we do know or we have appreciated, I'm going back to 2014 that there is an increased evidence of allergic d…

LDS Guidelines: Then vs. Now 42:15-44:56 In terms of pregnancy I don't know that there's a heck of a lot of new changes either since 2024, or 2014, something to be aware of is that the angiotensin receptor blockers that Dr. Dietz was descr…

LDS Guidelines: Then vs. Now 40:04-42:13 In terms of orthopedics, again when we were focused and had our knowledge mainly about Loeys-Dietz types one and two. We did see that many patients had cervical spine instability, so their spine and…

LDS Guidelines: Then vs. Now 39:07-40:01 So in terms of vascular surgery as well we really want to make sure in the upcoming guidelines that we get our vascular surgery colleagues involved. This is a slide again. My, some of you might have…

LDS Guidelines: Then vs. Now 33:36-38:54 So there are other medications that we suggested avoiding back in 2014. 2014年のガイドラインでは、避けることが推奨されていた薬があります。 One was a class of medications commonly used to treat migra…

LDS Guidelines: Then vs. Now 31:08-33:34 So we have now directly tested this in mouse models of Loeys-Dietz syndrome. I'm here using a calcium channel blocker, a common one called amlodipine. Importantly, in these studies it didn't matter …

LDS Guidelines: Then vs. Now 29:04-31:03 So we, as we've talked about we were, we and other groups are trying to understand what medications might be good for someone with a vascular connective tissue disorder. A different question that I …

LDS Guidelines: Then vs. Now 27:01-28:55 In terms of cardiovascular management, what we would say and continue to say is that people should be getting at least yearly echocardiograms. Clearly we're doing that a little bit more frequently i…

LDS Guidelines: Then vs. Now 26:27-26:59 Just as a reminder, you know, there is overlapping severity in all different types of Loeys-Dietz syndrome, kind of big picture in general. What we kind of say is TGFBR1 and 2 tend to, as a whole, b…

LDS Guidelines: Then vs. Now 24:41-26:25 In our 2014 guidelines we didn't really address any specific variant information and so that means that, you know, we have these six different types of Loeys-Dietz syndrome with gene variants or gen…

LDS Guidelines: Then vs. Now 24:14-24:39 Some questions have come up about well what about in your legs, what about aneurysms there? They have been reported in the literature, especially aneurysms kind of behind your knees called popliteal…

LDS Guidelines: Then vs. Now 21:49-24:13 In terms of vascular imaging guidelines these have generally remained the same. In the very beginning we are recommending head to pelvis imaging at baseline as well as imaging about every two years.…

LDS Guidelines: Then vs. Now 19:26-21:34 We're now understanding exactly why medications like losartan work in these conditions. Again by work that was done by Elena McFarlane we've learned that cells within the aortic root, so-called seco…

LDS Guidelines: Then vs. Now 17:55-21:34 So Elena McFarlane, another investigator at Johns Hopkins, who is in my lab at the time did a beautiful job of assessing mouse models of Loeys-Dietz syndrome. These mice show very dramatic aortic ro…

LDS Guidelines: Then vs. Now 16:20-17:51 So we had learned a lot about Marfan syndrome and its relationship to TGF beta. Loeys-Dietz syndrome we now know has six different identified genes. All of them relate directly to the TGF beta signa…

LDS Guidelines: Then vs. Now 10:33-16:15 So back 10 years ago we knew that Marfan syndrome related to alterations in the activity of a molecule called TGF beta. That's a mechanism by which cells talk to themselves or talk to each other and…

LDS Guidelines: Then vs. Now 7:54-10:15 So one of the big things that differentiated Loeys-Dietz syndrome from Marfan syndrome in the very beginning was this recognition, right? that aortic diameters could show dissections or tears at smal…

LDS Guidelines: Then vs. Now 6:30-7:47 So kind of a late breaking also research discovery that we wanted to bring forward is that there was a paper earlier this year that described a possible new Loeys-Dietz gene, so this is not clinically…

LDS Guidelines: Then vs. Now 4:23-6:27 So again, this is the, the primer that many specialists, most of them from Johns Hopkins, because back in the day we had the most experience with Loeys-Dietz, so our specialist came together to write …

New ACC/AHA Aortic Disease Management Guidelines: What do they mean for you? 1:05:49-1:07:41 Q:There's a lot of questions about PEARS surgery. Abe, are you comfortable talking about the PEARS? PEARSについての質問を多くいただいています。DeA…

New ACC/AHA Aortic Disease Management Guidelines: What do they mean for you? 1:05:09-1:05:47 Q:What percentage of Marfan patients will experience in aortic dissection or require surgery? マルファン患者で大動脈解離を発症する人の割合、外科手…

New ACC/AHA Aortic Disease Management Guidelines: What do they mean for you? 1:04:10-1:05:06 Q:Here's a question my daughter was diagnosed with Loeys-Dietz but dad and I were tested and don't have it. Should we get an echo to check the aor…

New ACC/AHA Aortic Disease Management Guidelines: What do they mean for you? 1:02:52-1:04:10 Q:Abe, maybe you can answer this if you have, if you know what's typically done with celiac and splenic artery dilations at what size is typically…

New ACC/AHA Aortic Disease Management Guidelines: What do they mean for you? 1:00:51-1:01:29 Q:When to start aortic, how old to start aortic screening relatives? 家系に結合組織疾患患者がいるのですが、その者の親族に対して大動脈の検査を行う…

New ACC/AHA Aortic Disease Management Guidelines: What do they mean for you? 59:51-1:00:45 Q:One person asked the important question. Is there a recommended age cutoff for peripheral aneurysms when considering genetic testing? 末梢の動脈瘤…

New ACC/AHA Aortic Disease Management Guidelines: What do they mean for you? 58:58-59:50 Q:Here's a question when my husband and children go to their cardiology appointments do they need an MR, CT as well as an echo? 夫と子供が循環器内科で…

New ACC/AHA Aortic Disease Management Guidelines: What do they mean for you? 55:40-58:02 And then we've talked about multiple dis.., multiple disciplinary aor.., multi-disciplinary aortic teams multiple times tonight, sometimes called cent…

New ACC/AHA Aortic Disease Management Guidelines: What do they mean for you? 54:38-55:36 Another section of the paper was talking about quality of life both in the importance of regular mild to moderate physical activity and if you're not …