Medical Treatment of Aortic Regurgitation

Aortic regurgitation has no medical treatment. The only true treatment is surgery.

Medicines are only useful in patients with high arterial pressure and in those operated on with ventricular dysfunction in which it has not improved after surgery. The most useful ones are the so called ACE inhibitors (captopril, enalapril, lisinopril, etc) and AT2 antagonists (losartán, valsartán, telmisartán, etc).

It’s important to state that no effect of these or other pills has been proven to delay surgery.

In patients with Marfan syndrome beta-blockers may slow down the growth of the aorta and reduce the risk of complications; their use is therefore recommended. AT2 antagonists may also offer a clinical benefit but this is not proven yet; they are also commonly prescribed if well tolerated (they reduce the arterial pressure).

Patients with Marfan or similar syndromes and those with aorta diameters close to surgical indication are advised against strenuous physical activity and isometric, contact or competition sports.

Source: Guidelines on the management of valvular heart disease (version 2012) The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)

European Heart Journal  doi:10.1093/eurheartj/ehs109