Nifedipine in Severe Aortic Regurgitation

To the Editor: It is unfortunate that Scognamiglio et al. (Sept. 15 issue) 1 chose to use digoxin instead of placebo to study the effects of nifedipine in asymptomatic patients with chronic, severe aortic regurgitation. Almost two decades since the short-term beneficial effects of vasodilator therapy in severe aortic regurgitation were first reported, 2 clinicians still await proof that vasodilator therapy reduces or delays the need for aortic-valve replacement in asymptomatic patients with severe, chronic aortic regurgitation. Although some authors 3 , 4 have promoted the routine use of vasodilators to delay the need for valve replacement in these patients, an informal survey we . . .