Assessment of subclinical left ventricular dysfunction in asymptomatic mitral regurgitation

The management of asymptomatic severe mitral regurgitation is showing an increasing trend towards early surgery. However, in situations where either the valve or the patient is not optimal for surgery, watchful waiting remains a reasonable policy. In this situation, the longstanding challenge of assessing left ventricular function in the setting of severe mitral regurgitation has been simplified by a number of investigations, including stress echocardiography and myocardial imaging. This paper reviews the evidence base for each of these techniques. (c) 2006 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved