The medical treatment of hemodynamically relevant MR due to MVP is based on angiotensin-converting enzyme inhibitors which promote a reduction in cardiac after-load by decreasing systemic vascular resistance, beta blockers which promote negative inotropic and chronotropic effects, decreasing cardiac demand, and oxygen demand and loop diuretics which promote a reduction in cardiac preload by decreasing the total blood volume [91]. This evidence concerns the gene ACE and miotic rate.