Aortic Valve Insufficiency (Aortic Regurgitation)

Pathological condition characterized by the backflow of blood from the ASCENDING AORTA back into the LEFT VENTRICLE, leading to regurgitation. It is caused by diseases of the AORTIC VALVE or its surrounding tissue (aortic root).

Also Known As:

Networked: 1799 relevant articles (57 outcomes, 141 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Aortic Valve Stenosis (Aortic Stenosis)
2.	Heart Failure
3.	Mitral Valve Insufficiency (Mitral Regurgitation)
4.	Endocarditis
5.	Mitral Valve Stenosis (Mitral Stenosis)

Experts

1.	Serruys, Patrick W: 19 articles (10/2021 - 06/2011)
2.	Svensson, Lars G: 17 articles (10/2022 - 11/2011)
3.	Abdel-Wahab, Mohamed: 16 articles (11/2021 - 11/2010)
4.	Colombo, Antonio: 15 articles (11/2022 - 01/2013)
5.	Latib, Azeem: 15 articles (11/2022 - 01/2013)
6.	Rodés-Cabau, Josep: 15 articles (11/2022 - 12/2009)
7.	Grube, Eberhard: 14 articles (01/2019 - 10/2006)
8.	Sinning, Jan-Malte: 13 articles (11/2022 - 01/2012)
9.	Guo, Yingqiang: 13 articles (08/2022 - 02/2015)
10.	Pibarot, Philippe: 13 articles (01/2022 - 05/2012)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Aortic Valve Insufficiency:

1.	Nitroprusside (Sodium Nitroprusside)FDA LinkGeneric 07/01/1979 - "Although nitroprusside improved cardiac function in both groups, only the patients with aortic regurgitation achieved normal pulmonary artery pressure (17 torr) and pulmonary vascular resistance (2.1 units) as a result of unloading. " 07/01/1979 - "Therefore, we conclude that patients with aortic regurgitation derived greater intraoperative hemodynamic benefit from unloading with nitroprusside, because they came to surgery with greater impairment of left ventricular contractility. " 07/01/1979 - "Comparison of intraoperative nitroprusside unloading in mitral and aortic regurgitation." 11/04/1976 - "These data indicate that afterload reduction with nitroprusside in severe aortic regurgitation improves cardiac performance, greatly decreases left ventricular preload and reduces aortic regurgitant volume. " 11/04/1976 - "To assess the hemodynamic effects of afterload reduction in severe aortic regurgitation, nitroprusside was infused at cardiac catheterization in 12 patients with aortic regurgitation. "
2.	Nifedipine (Adalat)FDA LinkGeneric 11/01/1984 - "In aortic regurgitation, the acute administration of nifedipine improved cardiac performance and reduced regurgitation at rest and during exercise as a result of afterload reduction and increased heart rate. " 01/01/1993 - "This study, therefore, shows the beneficial acute hemodynamic effect induced by nifedipine in asymptomatic patients affected by chronic aortic regurgitation and shows that Doppler-echocardiography is a useful instrument for the evaluation of hemodynamic changes immediately after the administration of drugs." 05/11/1995 - "Nifedipine in severe aortic regurgitation." 05/11/1995 - "Nifedipine in severe aortic regurgitation." 05/11/1995 - "Nifedipine in severe aortic regurgitation."
3.	Nitroglycerin (Dynamite)FDA LinkGeneric 02/01/1984 - "Resting end-systolic meridional and circumferential stress were increased in patients with aortic regurgitation (113.9 +/- 29 and 260 +/- 50.7 X 10(3) dynes/cm2) compared with those in normal subjects (85.6 +/- 15.4 and 214.1 +/- 28.4 X 10(3) dynes/cm2) (both p less than .01) and remained significantly greater after nitroglycerin. " 10/01/1991 - "The values of arterial compliance and total peripheral resistance were assessed during aortic regurgitation at different regurgitant orifice areas in eight pigs before and after a bolus of glyceryl trinitrate. " 10/01/1991 - "Haemodynamic effects of arterial compliance, total peripheral resistance, and glyceryl trinitrate on regurgitant volume in aortic regurgitation." 03/15/1989 - "Hemodynamic effects of nitroglycerin in an experimental model of acute aortic regurgitation." 02/01/1984 - "Ejection fraction in patients with aortic regurgitation and normal subjects were similar at rest (55 +/- 10% vs 59 +/- 6%) and were unchanged by nitroglycerin. "
4.	Adrenal Cortex Hormones (Corticosteroids)IBA 10/18/2023 - "We report a rare case of IgG4-RD-associated myocardial mass causing severe aortic incompetence, successfully treated with surgery and corticosteroids. " 01/01/2005 - "Other complications included residual shunt during 6 month follow-up in 1 case (0.4%), minor aortic regurgitation in 5 cases (2.0%), minor tricuspid regurgitation during 6 month follow-up in 4 cases (1.6%), and accelerated idioventricular rhythm or accelerated atrio-ventricular junctional tachycardia combined with atrioventricular interference-dissociation by ECG in 75 cases (29%) but they recovered after 3 - 5 days of corticosteroid treatment. " 01/01/2022 - "A 58-year-old Caucasian female elementary school teacher, with a history of generalized anxiety disorder (GAD), severe asymptomatic aortic regurgitation (AR), and TA in remission under corticosteroids, was admitted in the emergency department with worsening chest pain and dyspnea, initiated after a period of intense emotional stress (increased workload during COVID-19 pandemic). " 08/01/2001 - "We present a case of Cogan's syndrome in childhood presenting with arthralgia, myalgia, anorexia, uveitis, aortic regurgitation, and intermittent fever and who responded well to corticosteroid therapy and successful valvular replacement. " 05/01/2012 - "Cardiac BD affects males more than females, and is prone to delayed diagnosis because some patients do not have typical clinical manifestations at cardiac onset; Corticosteroids plus immunosuppressants reduce the thrombus and improve aortic regurgitation and heart failure in cardiac BD, whereas surgery alone does not lead to complete resolution."
5.	Radioisotopes (Radionuclides)IBA 02/01/1989 - "These results suggest that radionuclide angiography performed during exercise is effective in the early detection and accurate evaluation of myocardial dysfunction in patients with chronic aortic regurgitation at the asymptomatic stage.(ABSTRACT TRUNCATED AT 250 WORDS)" 04/01/1995 - "To study the relationship between symptoms and left ventricular function in 68 patients with severe chronic aortic regurgitation using echocardiogram and radionuclide left ventriculography at rest. " 01/01/1990 - "54 patients with aortic regurgitation underwent pre- and postoperative as well as long-term follow-up radionuclide ventriculographic (RNV) studies in order to determine LVEDV and RV and to measure left ventricular ejection fraction (LVEF). " 11/01/1987 - "Radionuclide assessment of diastolic function in aortic regurgitation: a critical study of its measurement." 09/01/1985 - "Rest-exercise radionuclide angiographic assessment of left ventricular function in chronic aortic regurgitation: significance of serial studies in medically versus surgically treated groups."
6.	Vasodilator Agents (Vasodilators)IBA 09/01/2011 - "This article summarizes the clinical studies that have evaluated vasodilators in asymptomatic patients with chronic aortic regurgitation. " 09/01/1990 - "[Spectral analysis and color-coded Doppler study of the changes in aortic regurgitation induced by vasodilators in asymptomatic patients with severe aortic insufficiency]." 10/01/2012 - "Vasodilators have favorable effects on LV remodelling in asymptomatic patients with chronic moderate to severe aortic regurgitation and normal LV function. " 01/01/2009 - "Comparative study of vasodilators in an animal model of chronic volume overload caused by severe aortic regurgitation." 03/01/2008 - "In the field of aortic regurgitation, the use of vasodilators to forestall surgery has been called into doubt by newer data; thus, recommendations for vasodilator use have been softened. "
7.	Angiotensin-Converting Enzyme Inhibitors (ACE Inhibitors)IBA 03/01/2004 - "The efficacy of angiotensin-converting enzyme inhibitors (ACEIs) in the treatment of chronic aortic regurgitation (AR) is not well established and remains controversial. " 09/01/1994 - "To date, no controlled study has been reported analyzing long term influence of ACE inhibitor treatment on asymptomatic patients with chronic aortic regurgitation. " 12/01/1997 - "Long-term treatment with ACE-inhibitors improves left ventricular function in patients with aortic regurgitation. " 01/01/2015 - "Subjects receiving ACE inhibitor therapy were compared with controls with BAV and matched for the degree of aortic regurgitation. " 02/01/2001 - "This review has been focused on the new insights in the pathophysiology of mitral and aortic regurgitation and on the role of ACE-inhibitor therapy in children with chronic volume overload due to left-sided valvular lesions. "
8.	Hydralazine (Apresoline)FDA LinkGeneric 04/01/1990 - "Beneficial long-term effects of hydralazine in aortic regurgitation." 06/01/1984 - "Favorable effects of hydralazine on the hemodynamic response to isometric exercise in chronic severe aortic regurgitation." 08/01/1983 - "Hydralazine also produces beneficial hemodynamic effects in patients with mitral and aortic regurgitation and in some patients with large ventricular septal effect with reduced systemic output. " 05/01/1983 - "Oral hydralazine reduces left ventricular internal diameters, improves left ventricular performance, presumably at a lower level of oxygen consumption, and improves exercise capacity in patients with modest mitral or aortic incompetence." 05/01/1983 - "Twenty-two patients with mild or moderate mitral or aortic incompetence were randomly assigned to treatment with either hydralazine (mean 127 mg/day, range 37-225) or placebo. "
9.	Digoxin (Digitek)FDA LinkGeneric 06/01/1989 - "These data suggest that digoxin improved left ventricular performance and may be of benefit in the treatment of patients with chronic aortic regurgitation." 06/01/1989 - "Effect of digoxin and vasodilators on left ventricular function in aortic regurgitation." 05/01/2020 - "A risk score system was constructed with the following predictors: body mass index, diastolic blood pressure, dyslipidemia, diabetes, aortic regurgitation, QRS duration, hemoglobin concentration, and digoxin usage. " 05/01/1980 - "In this group of patients with severe aortic regurgitation but without severe cardiac failure, the changes with either drug, studied in doses conventionally used, were small but those with prazosin were directionally more desirable than those resulting from digoxin." 07/01/1995 - "Fifty-eight dogs with dilated cardiomyopathy (35 dogs), mitral regurgitation (22 dogs), or aortic regurgitation (1 dog) receiving conventional therapy for heart failure (furosemide with or without digoxin) were included in a randomized double-blind study. "
10.	TaurineFDA Link 04/01/1987 - "In rabbits with aortic regurgitation a bolus injection of taurine improved cardiac performance. " 08/01/1984 - "Cardiac function (max dP/dt) was significantly decreased in rabbits with aortic regurgitation, whereas in taurine-treated rabbits, cardiac function was maintained the same as control. " 08/01/1984 - "Nine rabbits were treated daily with taurine (100 mg/kg) after producing aortic regurgitation. " 08/01/1984 - "The present study was designed to see whether oral treatment with taurine could improve the status of congestive heart failure induced by aortic regurgitation. " 12/01/1986 - "To examine the effect of daily treatment with taurine on improving the status of congestive heart failure (CHF), we used rabbits with artificially induced aortic regurgitation. "

Therapies and Procedures

1.	Transcatheter Aortic Valve Replacement 01/01/2021 - "The balloon-expandable SAPIEN 3 (S3) is superior to the older-generation balloon-expandable SAPIEN XT (XT) in a lower incidence of paravalvular aortic regurgitation, lower complication rates and better survival in transcatheter aortic valve implantation (TAVI). " 01/01/2022 - "This report offers some guidance for treating patients with existing apicoaortic conduits and suggests that transcatheter aortic valve replacement is safe and effective if native aortic valve insufficiency develops." 01/01/2023 - "Procedural success and clinical outcomes after transcatheter aortic valve replacement (TAVR) have improved, but residual aortic regurgitation (AR) and new permanent pacemaker implantation (PPI) rates remain variable because of a lack of uniform periprocedural management and implantation. " 12/01/2020 - "This is a large-scale single-center study to evaluate the safety and efficacy of transcatheter aortic valve replacement in treating aortic regurgitation." 01/01/2023 - "Evidence about safety and efficacy of transcatheter aortic valve replacement (TAVR) with the Venus A-Valve system (Venus Medtech, Hangzhou, China) remains limited for patients with pure native aortic regurgitation (PNAR). "
2.	Therapeutics 02/01/1996 - "The clinical picture of traumatic aortic regurgitation is quickly evolutionary and the non efficacy of medical therapy has placed the valvular substitution surgery as the best succeeded treatment. " 01/01/2023 - "Current clinical guidelines have no specific recommendations regarding medical therapy after surgical aortic valve replacement in patients with aortic regurgitation (AR). " 01/01/2023 - "Medical therapy after surgical aortic valve replacement for aortic regurgitation." 01/01/2023 - "The clinical outcome of severe aortic regurgitation (AR) remains suboptimal, but surgery has been shown to have survival benefit over medical therapy. " 01/01/2020 - "Considering aortic root evolution, aortic regurgitation, age at diagnosis and beta-blocker therapy were related to Valsalva sinus Z-score evolution during follow-up. "
3.	Prostheses and Implants (Prosthesis) 10/15/2017 - "Second-generation TAVR devices are associated with very low mortality and major complications rates at 30-day, and improved prosthesis performance with <2% of patients having more than mild post-procedural aortic regurgitation. " 03/01/2016 - "Advances in prostheses and delivery system designs and continuous advances in multimodality imaging, particularly the 3-dimensional techniques, have led to improved outcomes with significant reductions in the incidence of frequent complications such as paravalvular aortic regurgitation. " 01/01/2019 - "Post/preprocedural ratio of hemodynamically assessed aortic regurgitation index as a marker for the need for corrective measures during transcatheter valve replacement: A first confirmatory study in patients receiving a new generation transcatheter self-expandable prosthesis." 01/01/2016 - "A total of 100 subjects was enrolled in the study, including 65 consecutive patients who had undergone TAVI with a CoreValve prosthesis and without valvular aortic regurgitation, and 35 normal controls. " 01/01/2015 - "The study aim was to investigate prosthesis-specific predictors for paravalvular aortic regurgitation (PAR) in self-expandable versus balloon-expandable transcatheter heart valves (THVs). "
4.	Heart-Assist Devices 11/01/2012 - "Continuous flow (CF) left ventricular assist devices (LVADs) have yielded improved outcomes in patient survival and quality of life compared with first-generation pulsatile pumps; however, they have been associated with an increased incidence of postimplant aortic valve insufficiency (AI), which can have can have serious clinical consequences if not diagnosed and treated expeditiously. " 01/01/2023 - "We assessed the incidence, predictors and clinical correlates of de-novo aortic regurgitation (AR), which physiologically reduces left ventricular assist device (LVAD) effectiveness due to recirculation syndrome, in the MOMENTUM 3 trial portfolio of the fully magnetically levitated HeartMate 3 (HM3) pump using the randomized pivotal trial (PT) and post-trial continued access protocol (CAP). " 01/01/2023 - "Incidence and clinical correlates of de-novo aortic regurgitation with a fully magnetically levitated left ventricular assist device: a MOMENTUM 3 trial portfolio analysis." 12/29/2022 - "This study aimed to investigate the outcomes of surgical interventions for symptomatic moderate-to-severe aortic regurgitation (AR), including aortic valve replacement (AVR) and repair (AVP), in 184 patients who underwent continuous flow-left ventricular assist device (Cf-LVAD) implantation as a bridge-to-transplant (BTT) between November 2007 and April 2020. " 01/01/2022 - "The aim of this study was to identify the optimal echocardiographic measurement of aortic regurgitation (AR) in continuous flow left ventricular assist devices (LVAD) and determine risk factors and clinical implications of de novo AR. "
5.	Bioprosthesis 04/01/2013 - "TAVI with the CRS bioprosthesis is feasible and effective in appropriately selected cases of severe aortic regurgitation in native and bioprosthetic aortic valves." 09/04/1992 - "Despite this the cardiac status deteriorated, the aortic regurgitation reaching grade IV. The valve was replaced with a bioprosthesis and the patient quickly improved postoperatively. " 04/17/2023 - "Echocardiography showed a deteriorating aortic bioprosthesis with severe aortic regurgitation. " 01/01/2021 - "Compared with an older-generation internally mounted bovine pericardial valve, the Trifecta externally wrapped bioprosthesis exhibits superior early hemodynamic performance, but has a rapid increase in transvalvular gradient and more aortic regurgitation, with lower freedom from explant at 5 years. " 01/01/2021 - "In the reoperation, the left coronary leaflet of the bioprosthesis had attached and fused to the wall of the sinus of Valsalva, causing deformation of the valve leaflet and a commissural gap between the left and right coronary leaflets, which appeared to have caused the de novo aortic regurgitation. "