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Endothelial-specific MR deletion prevented fibromyxomatous changes induced by NDF administration. Moreover, proteoglycan expression was slightly lower in the mitral valves of MVP patients treated with MRA. Conclusions These findings demonstrate, for the first time, that the Aldo/MR pathway regulates the phenotypic, molecular, and histological changes of VICs and VECs associated with MVP development. MRA treatment appears to be a promising option to reduce fibromyxomatous alterations in MVP.William Rutherford Sanders (1828-1881) was an Edi