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: 1001 relevant articles (32 outcomes, 59 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

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

Experts

1.	Grube, Eberhard: 7 articles (09/2014 - 10/2006)
2.	Couet, Jacques: 7 articles (09/2013 - 03/2004)
3.	Arsenault, Marie: 7 articles (09/2013 - 03/2004)
4.	Ko, Jong Mi: 7 articles (01/2012 - 12/2005)
5.	Roberts, William Clifford: 7 articles (01/2012 - 12/2005)
6.	Delgado, Victoria: 6 articles (10/2015 - 01/2010)
7.	Hamman, Baron Lloyd: 6 articles (01/2012 - 08/2007)
8.	Hebeler, Robert Frederick: 6 articles (01/2012 - 08/2007)
9.	Colombo, Antonio: 5 articles (01/2016 - 01/2013)
10.	Bax, Jeroen J: 5 articles (10/2015 - 05/2009)

Drugs and Biologics

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

1.	Nitroprusside (Sodium Nitroprusside)FDA LinkGeneric 04/01/1982 - "In patients with aortic regurgitation, vasodilator therapy was effective in increasing forward output only in 2 patients who had an initially elevated end-diastolic pressure which was reduced only to levels slightly above normal with nitroprusside. " 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. " 11/04/1976 - "Afterload reduction therapy with nitroprusside in severe aortic regurgitation: improved cardiac performance and reduced regurgitant volume." 11/01/1980 - "After load reduction therapy with nitroprusside in chronic severe aortic regurgitation. " 05/01/1980 - "Intravenous administration of the vasodilator sodium nitroprusside has beneficial haemodynamic effects in subjects with severe aortic regurgitation while acute digitalisation can produce unwanted effects associated with an increase in systemic vascular resistance. "
2.	Nifedipine (Adalat)FDA LinkGeneric 09/01/2001 - "Left ventricular outflow tract obstruction unmasked by nifedipine: a therapeutic pitfall in the management of chronic aortic regurgitation." 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." 08/01/1990 - "To evaluate the effects of 12 months of therapy with nifedipine, a randomized, double-blind, placebo-controlled trial was performed in 72 asymptomatic patients with severe aortic regurgitation. " 09/01/2001 - "This case report illustrates the aggravation of a clinically silent left ventricular outflow tract obstruction by maintenance use of nifedipine in a patient with chronic severe aortic regurgitation, and demonstrates a potential limitation of vasodilator therapy in the management of this patient population. "
3.	Hydralazine (Apresoline)FDA LinkGeneric 04/01/1990 - "Beneficial long-term effects of hydralazine in aortic regurgitation." 05/01/1986 - "Effects of six-month afterload reduction therapy with hydralazine in chronic aortic regurgitation." 06/01/1984 - "The hemodynamic effects of isometric exercise and the response to hydralazine therapy were evaluated in 11 patients with chronic, severe aortic regurgitation (AR). " 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. "
4.	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. " 12/01/1997 - "Long-term treatment with ACE-inhibitors improves left ventricular function in patients with aortic regurgitation. " 01/01/2006 - "ACE inhibitors induce a small increase in left ventricular ejection fraction, left ventricular fractional shortening, and systemic blood flow in children with left ventricular dysfunction, mitral regurgitation, and aortic regurgitation. " 02/01/1996 - "Long-term treatment with angiotensin-converting enzyme (ACE) inhibitors has beneficial effects in patients with chronic aortic regurgitation by reducing left ventricular volumes and regurgitant fraction. " 11/01/1996 - "In studies of long-term vasodilator therapy in patients with chronic aortic regurgitation, a reduction in left ventricular volumes and regurgitant fraction, with or without an increase in ejection fraction, has been observed during treatment with hydralazine, nifedipine and ACE inhibitors. "
5.	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." 05/01/1980 - "This study compares the haemodynamic effects of the vasodilator prazosin and digoxin in eight patients with isolated severe aortic regurgitation. " 09/15/1994 - "To assess whether vasodilator therapy reduces or delays the need for valve replacement, we randomly assigned 143 asymptomatic patients with isolated, severe aortic regurgitation and normal left ventricular systolic function to receive either nifedipine (20 mg twice daily, 69 patients) or digoxin (0.25 mg daily, 74 patients). " 06/01/1989 - "Effect of digoxin and vasodilators on left ventricular function in aortic regurgitation." 05/01/1980 - "Comparison of vasodilator drug prazosin with digoxin in aortic regurgitation."
6.	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. "
7.	EnalaprilFDA LinkGeneric 02/01/1996 - "Velocity-encoded cine magnetic resonance imaging was used in 9 patients with moderate to severe aortic regurgitation (regurgitant fraction 49% +/- 17%) to measure regurgitant fraction, regurgitant volume, and forward stroke volume at baseline and 3 months after therapy with enalapril (mean dose 29 +/- 13 mg). " 10/01/1994 - "These findings suggest that early unloading enalapril therapy has the potential to favorably influence the natural history of chronic aortic regurgitation." 10/01/1994 - "Because the renin-angiotensin system may be activated in chronic aortic regurgitation, early enalapril therapy might be beneficial. " 10/01/1994 - "This study attempted to evaluate the long-term efficacy of enalapril versus hydralazine therapy on left ventricular volume, mass and function as well as on the renin-angiotensin system in chronic asymptomatic aortic regurgitation. " 10/01/1994 - "Between 1990 and 1993, 76 asymptomatic nonrheumatic patients with mild to severe chronic aortic regurgitation were enrolled in a randomized, double-blind trial comparing enalapril with hydralazine. "
8.	PerindoprilFDA LinkGeneric 09/01/2002 - "Twenty male Sprague-Dawley rats, in which aortic regurgitation was produced, were divided into untreated and perindopril-treated (5 mg x kg(-1) x d(-1)) rats. " 09/01/2002 - "We investigated the effects of the ACE inhibitor perindopril on cardiac performance, myocardial energy efficiency, and uncoupling protein expression in an aortic regurgitation rat model. " 11/01/2000 - "Effects of perindopril on left ventricular remodeling and aortic regurgitation in rats assessed by echocardiography." 09/01/2002 - "In the chronic stage of aortic regurgitation, perindopril improved cardiac performance and myocardial energy efficiency, in which the suppression of uncoupling protein-2 may play an important role." 11/01/2000 - "This study investigated the effect of the angiotensin-converting enzyme (ACE) inhibitor perindopril on left ventricular (LV) remodeling and cardiac function in rats with aortic regurgitation (AR). "
9.	Captopril (Capoten)FDA LinkGeneric 09/01/1997 - "To verify the efficacy of long-term captopril therapy to reduce left ventricular mass and dimensions in patients with severe chronic aortic regurgitation. " 04/01/1998 - "Beneficial effects of 1-year captopril therapy in children with chronic aortic regurgitation who have no symptoms." 09/01/1997 - "These results suggest that captopril has a favourable effect on left ventricular mass, dimensions and load conditions, and could favourably influence the natural history of chronic aortic regurgitation. " 03/01/1994 - "Six month pilot study of captopril for mildly symptomatic, severe isolated mitral and isolated aortic regurgitation." 05/01/1986 - "In 16 patients with chronic aortic regurgitation, we studied the acute hormonal and hemodynamic effects of 12.5 to 25 mg captopril; in 12 patients the changes after a 4 to 8 week treatment period (mean 6.3 +/- 2 weeks; doses: 3 times 12.5 to 3 times 25 mg/day) were investigated. "
10.	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. "

Therapies and Procedures

1.	Sutures (Suture) 08/01/1981 - "We think this surgical technique is superior to closure of these openings by primary sutures only, which can result in stretching and distortion of the aortic ring and leaflets leading to postoperative residual aortic regurgitation." 11/01/2006 - "In this technique, the possibility of aortic regurgitation caused by stretching and distortion of the aortic ring and leaflets by primary suture closure of tunnel is eliminated. " 10/01/1980 - "In one patient, simply cutting the overhanging suture eliminated the aortic regurgitation. " 09/01/2014 - "Two patients experienced relevant recurrent aortic regurgitation for limited suture dehiscence between the patch and the cusp and were reoperated on between 16 and 32 months postoperatively. " 09/01/2007 - "Capnocytophaga haemolytica was isolated in blood cultures and the repeated echocardiograms showed growth of vegetations and disruption of the proximal prosthetic valve suture line with progressive aortic regurgitation. "
2.	Catheters 07/01/1996 - "An improved valve-spreading catheter for producing reversible graded acute aortic regurgitation." 01/01/1991 - "The mean rate of increase of gradient was 6.5 mmHg per year, and was significantly faster in patients in whom there was aortic valve calcification or aortic regurgitation present at the first catheter study (P less than 0.02). " 10/01/1990 - "[Use of original valve devices on a catheter in the correction of aortic valve insufficiency (results of testing unit studies]." 04/01/2015 - "Post-procedural aortic regurgitation (AR) negatively impacts the prognosis after trans-catheter aortic valve implantation. " 07/01/2014 - "Quantification of aortic regurgitation by measurement of time-density changes on contrast aortography may improve the reproducibility of AR assessment in the catheter laboratory. "
3.	Transplants (Transplant) 03/01/1998 - "Although currently some surgeons prefer to resuspend rather than replace the aortic valve, composite valve graft replacement for aortic root dilatation and aortic valve insufficiency has steadily improved patient outcome. " 11/05/2015 - "In this study we use computer simulation and ex vivo experiments to explore a surgical repair method that has the potential to treat a particular form of congenital aortic regurgitation without the introduction of graft material. " 10/01/2000 - "The objective of this study was to create native aortic valve insufficiency in recipient rats to provide for a functional abdominal aortic valve graft implant. " 10/01/2015 - "The percentage of under- or oversized implanted grafts was calculated and the association between the adequacy of graft sizing using TTE-derived formulas and the incidence of residual aortic regurgitation (AR) was evaluated retrospectively. " 09/01/2015 - "To quantify the range of blood flow parameters in ascending aorta that can result from various angulations of outflow graft anastomosis of a left ventricular assist device (LVAD) to the aortic wall, as a means to understand the mechanism of aortic valve insufficiency. "
4.	Stents 12/01/2013 - "Percutaneous valved stent implantation in the ascending aorta is feasible, effective, and safe as an alternative treatment for very high-risk aortic regurgitation in a canine model." 12/01/2013 - "Percutaneous valved stent implantation in the ascending aorta for the treatment of very high-risk aortic regurgitation: an animal study." 12/01/2012 - "The aim of this paper was to develop a new self-expandable aortic valved stent following the shape of the sinus of Valsalva, which can be deployed above native leaflets for aortic regurgitation, and study it's effect on coronary artery flow when orthotopic implantation in and above native leaflets. " 10/01/2014 - "Experience with transcatheter aortic valve implantation (TAVI) for severe aortic regurgitation is limited due to the risk of insufficient anchoring of the valve stent within the noncalcified aortic annulus. " 12/01/2013 - "The level of instantaneous aortic regurgitation at 3-mo follow-up was significantly reduced compared with that before valved stent implantation (2.4 ± 0.9 versus 10.6 ± 2.1 mL/s, P < 0.05). "
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. " 02/01/2013 - "The purpose of the study was to investigate the impact of a prospective policy of "oversizing" the Edwards SAPIEN bioprosthesis (Edwards Lifesciences LLC, Irvine, Calif) relative to the diameter of the aortic annulus on the rate and severity of aortic regurgitation in 28 consecutive patients initially considered eligible for transcatheter aortic valve implantation on the basis of angiography, multislice computed tomography, and transthoracic echocardiography. " 10/01/2015 - "In patients with moderate to severe aortic regurgitation, surgical approaches are center specific and range from variable leaflet closure techniques to concomitant aortic valve replacement (AVR) with a bioprosthesis. " 06/01/2015 - "We aim to investigate the feasibility of transcatheter aortic valve-in-valve implantation via the transcarotid access in patients with severe aortic regurgitation due to degenerated stentless Shelhigh conduits using the 29 mm Medtronic CoreValve bioprosthesis. "