Figure 50-21 Pathophysiology of aortic regurgitation. Aortic regurgitation results in an increased left ventricular (LV) volume, increased stroke volume, increased aortic (Ao) systolic pressure, and decreased effective stroke volume. Increased LV volume results in an increased LV mass, which may lead to LV dysfunction and failure. Increased LV stroke volume increases systolic pressure and prolongation of left ventricular ejection time (LVET). Increased LV systolic pressure results in a decrease in diastolic time. Decreased diastolic time (myocardial perfusion time), diastolic aortic pressure, and effective stroke volume reduce myocardial O₂ supply. Increased myocardial O₂ consumption and decreased myocardial O₂ supply produce myocardial ischemia, which further deteriorates LV function. ↑, Increased; ↓, decreased). (Redrawn from Boudoulas H, Gravanis MB: Valvular heart disease. In Gravis MB [ed]: Cardiovascular Disorders: Pathogenesis and Pathophysiology. St Louis, CV Mosby, 1993.)