Aortic valve regurgitation (AR) imposes a severe volume overload to the left ventricle (LV) which results in dilation, eccentric hypertrophy and eventually loss of function. Little is known about the impact of AR on LV gene expression. We therefore conducted a gene expression profiling study in the LV of rats with acute and severe AR. We identified 64 genes that were specifically up-regulated and 29 that were down-regulated out of 21910 genes after 2 weeks. Of the up-regulated genes, a good proportion was related to the extracellular matrix. We subsequently studied a subset of 19 genes by quantitative RT-PCR (qRT-PCR) to see if the modulation seen in the LV after two weeks persisted in the chronic phase (after 6 and 12 months) and found that it did persist. Knowing that the -adrenergic and renin-angiotensin systems are over-activated in our animal model, we were interested to see if blocking those systems using metoprolol (25 mg/kg/d) and captopril (100 mg/kg/d) would alter the expression of some up-regulated LV genes in AR rats after 6 months. By qRT-PCR we observed that up-regulations of LV mRNA levels encoding for pro-collagens type I and III, fibronectin, atrial and brain natriuretic peptide (ANP and BNP), transforming growth factor 2 (TGF2) and connective tissue growth factor (CTGF) were totally or partially reversed by this treatment. These observations provide a molecular rationale for a medical strategy aiming these systems in the medical treatment of AR and expand the paradigm in the study of this form of LV volume overload.