There is no medical therapy that can delay the need for surgical repair/replacement of the mitral valve in severe mitral regurgitation. Studies have been performed using ACE inhibitors and dihydropyridine calcium channel blockers. Only one small study using nifedipine showed a potential benefit. Certainly, control of afterload with the above medications with improve hemodynamics and cardiac output in the presence of severe mitral regurgitation, but has not been shown to delay the need for valve repair/replacement.