Beta blocker Benefits for Aortic Valve Regurgitation ?

[al]

Is there any information on or studies conducted regarding the benefits and use of beta blockers for people who have aortic valve leakage ?

My problem is that my current cardiologist of 2-3 yrs has taken me off the combination of a generic beta blockers(10mg x2/day) and vasotec(5 mg x2/day) which was recommended by my previously cardiologist for 20 years(moved out of area)to 10 mg Zestrel(1x/day).  Recent studies (muga) and echo indicated a ejection fraction of 52%. Over the previous 20 yrs I was told that my status was improving over the that period of time. Contacting my old cardiologist he states that there is a benefit of using a beta blocker and infact would recommend the use of Coreg...I guess an improved beta blocker.  When I delicately proposed "would going back on a beta blocker be of any benefit", his answer was probably not,could do damage and unless I wanted to start a random statistical trial he saw no benefit. He also started to rattle off a series of names who are experts in the field. (I got this feeling he was not pleased that I asked any question so I will probably try to find another cardiologist)  

I know this area is not an exact science and I know there are many opinions on the subject but just wanted to know from the experts any pros or cons on the use of beta blockers for folks who have aortic valve regurgitation or even if beta blockers would possible delay the further degeneration of the valve / heart.  That is, would beta blocker or Corig be a benefit for the prevention of future problems.  Any studies ?

Many thanks to simply an outstanding site !!

al

[Cleveland Clinic, MD]

Dear Al,

There is some evidence that ace inhibitors such as zestril increase the time until surgery is needed with aortic regurgitation.  I don't know of similar data with beta-blockers.  However, it's not clear to me if the benefit from ACE inhibitors is due to their blood pressure lowering properties or something else.  If it is only due to blood pressure lowering then beta-blockers may also work in a similar fashion.  

It appears you do have some trust issues with your current cardiologist and it may be wise to find someone you feel comfortable with.  There is nothing wrong with asking questions, remember you're paying a doctor for their answers.

[Gail]

I am taking Cozaar, an ACE inhibitor, to prolong the time that I will need another heart surgery. I have moderate leakage of my mitral valve. I had a porcine valve (aortic) go after 11 years and had another surgery 7 months ago. I was too sick for both valves to be done at that time. So, hopefully, by taking this drug, it will give me maybe 10 years before I need to have the mitral valve dealt with. This is what the surgeon says, but my last surgeon said my porcine valve could last 15-20 years and come to find out they are really only good for about 10 at the most.  Anyway , they started me on vasotec and then I was switched to prinivil but they made me cough. I do not cough with the Cozaar. A good dr. should know about these studies on valve leakage and ace inhibitors. Good Luck!

[Brenda]

I had my aortic valve replaced 11 years ago with a homograft. Since then I have only been on ecotrin. Last month my cardiologist started me on Coreg to "strengthen my heart." I have been trying to do some research  on the use of this medication. Most of what I have read seems to indicate that Coreg is used for congestive heart failure or high blood pressure. I do not have high blood pressure, and I did not think I was in CHF. I would like to find out how widespread the use of this drug is for patients with aortic valve problems. It appears from the MD's answer above, that the Cleveland Clinic doctors are not using it. I wonder why?

[Ted]

AL-I am speaking on behalf of my mentally retarded who was diagnosed with Aortic Valve Regurgitation in 1992. Do doctors tell you that you have to have a beta-blocker for AVR?He only had an echocardiogram but no MUGA test.Which test shows ejection fraction? He takes Monopril and 330mg Dilantin for seizure control.He is 6' 2" and has gone from 169 to 147 lbs in 8 months with same routine as before.Have your doctors told you that you can loose weight from AVR with or without proper medication? I need some answers before I pursue Addisons disease etc. Thank you-Ted