What is the primary effect of long-standing aortic regurgitation?

Long-standing aortic regurgitation leads to the volume overload of the left ventricle. This occurs because blood leaks back into the left ventricle from the aorta during diastole, in addition to the normal inflow of blood from the left atrium. As a result, the left ventricle compensates for this increased volume by undergoing eccentric hypertrophy to accommodate the extra blood.

Over time, this compensatory mechanism can reach its limits, and the heart may begin to weaken. The contractile function of the left ventricle declines, leading to a decrease in ejection fraction. A reduced ejection fraction is a key indicator of heart function and signifies that the heart is not able to pump blood effectively, further exacerbating the symptoms related to aortic regurgitation. Therefore, decreased ejection fraction is the primary effect of long-standing aortic regurgitation.