Cardiac therapies have included ACE inhibitors for worsening mitral regurgitation and heart failure (Wakami et al., 2022; Massin et al., 1999), digoxin and diuretics (Singh et al., 2013; Yoshida et al., 2015), and angiotensin II receptor antagonists pre-surgery (Yoshida et al., 2015). This evidence concerns the gene ACE and mitral valve insufficiency.