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We systematically reviewed\u00a0clinical practice guidelines and summarized similarities and differences in the recommendations as well as gaps in evidence on the management of AR.<\/jats:p>\n               <jats:p>We searched MEDLINE and Embase (1 January 2011 to 1 September 2021), Google Scholar, and websites of relevant organizations for contemporary guidelines that were rigorously developed as assessed by the Appraisal of Guidelines for Research and Evaluation II tool. Three guidelines met our inclusion criteria. There was consensus on the definition of severe AR and use of echocardiography and of multimodality imaging for diagnosis, with emphasis on comprehensive assessment by the heart valve team to assess suitability and choice of intervention. Surgery is indicated in all symptomatic patients and aortic valve replacement is the cornerstone of treatment. There is consistency in the frequency of follow-up of patients, and safety of non-cardiac surgery in patients without indications for surgery. Discrepancies exist in recommendations for 3D imaging and the use of global longitudinal strain and biomarkers. Cut-offs for left ventricular ejection fraction and size for recommending surgery in severe asymptomatic AR also vary. There are no specific AR cut-offs for high-risk\u00a0surgery and the role of percutaneous intervention is yet undefined. Recommendations on the treatment of mixed valvular disease are sparse and lack robust prospective data.<\/jats:p>","DOI":"10.1093\/ehjqcco\/qcac001","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T20:15:53Z","timestamp":1641413753000},"page":"113-126","source":"Crossref","is-referenced-by-count":12,"title":["Aortic regurgitation management: a systematic review of clinical practice guidelines and recommendations"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5871-0900","authenticated-orcid":false,"given":"Victor","family":"Galusko","sequence":"first","affiliation":[{"name":"Department of Cardiology, King's College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Thornton","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK"},{"name":"Institute of Cardiovascular Science, University College London, London WC1E 6DD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3921-763X","authenticated-orcid":false,"given":"Csilla","family":"Jozsa","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK"},{"name":"Department of Cardiology, Newham University Hospital, Barts Health NHS Trust, Glen Road, London E13 8SL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baskar","family":"Sekar","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester GL1 3NN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dincer","family":"Aktuerk","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1560-7414","authenticated-orcid":false,"given":"Thomas A","family":"Treibel","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK"},{"name":"Institute of Cardiovascular Science, University College London, London WC1E 6DD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen E","family":"Petersen","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK"},{"name":"NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London EC1A 7BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Ionescu","sequence":"additional","affiliation":[{"name":"Morriston Hospital, UK Cardiac Regional Centre, Swansea Bay Health Board, Swansea SA6 6NL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Ricci","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Imaging and Clinical Sciences, \u2018G.d\u2032Annunzio\u2019 University of Chieti\u2013Pescara, 66100 Chieti, Italy"},{"name":"Department of Clinical Sciences, Lund University, Jan Waldenstr\u00f6ms gata 35, -205 02, Malm\u00f6, Sweden"},{"name":"Casa di Cura Villa Serena, 65013 Citt\u00e0 Sant'Angelo, Pescara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5903-4454","authenticated-orcid":false,"given":"Mohammed Y","family":"Khanji","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK"},{"name":"Department of Cardiology, Newham University Hospital, Barts Health NHS Trust, Glen Road, London E13 8SL, UK"},{"name":"NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London EC1A 7BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,13]]},"reference":[{"key":"2022051909123964500_bib1","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1161\/CIRCULATIONAHA.104.488825","article-title":"Valvular heart disease: aortic regurgitation","volume":"112","author":"Bekeredjian","year":"2005","journal-title":"Circulation"},{"key":"2022051909123964500_bib2","doi-asserted-by":"crossref","first-page":"e005155","DOI":"10.1161\/CIRCIMAGING.116.005155","article-title":"Sex differences in phenotypes of bicuspid aortic valve and aortopathy: insights from a large multicenter, international registry","volume":"10","author":"Kong","year":"2017","journal-title":"Circ Cardiovasc Imaging"},{"key":"2022051909123964500_bib3","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1161\/01.CIR.99.14.1851","article-title":"Mortality and morbidity of aortic regurgitation in clinical practice. 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