Cardiac Involvement in Chronic Aortic Regurgitation: Interpreting a Novel Staging Framework

hronic aortic regurgitation (AR) has long been approached primarily through the lens of left ventricular (LV) remodeling. LV size and systolic function, central to contemporary guideline recommendations, have shaped decision-making for decades. 1 Yet many patients with moderate to severe AR present with a wider constellation of structural and functional findings involving the left atrium, mitral valve, pulmonary vasculature, tricuspid valve, and right ventricle. These features reflect not only the hemodynamic burden of the regurgitant lesion but also age, vascular load, diastolic properties, atrial rhythm, and comorbidity profiles. In routine practice, AR is more often embedded within this broader cardiac landscape than in isolation.