Exercise echocardiography in the evaluation of severity of functional mitral regurgitation in patients with heart failure.

We present two cases with ischemic cardiomyopathy and similar functional mitral regurgitation (fMR) at rest, who represented different outcomes following mitral valve repair. In case 1, fMR was enhanced during exercise echocardiography, and his symptoms were improved following the repair and coronary artery bypass graft (CABG). In case 2, fMR did not change during exercise, and the improvement of his symptoms was small following the operation. Exercise echocardiography evidenced variability of the dynamic changes in fMR in patients with ischemic cardiomyopathy. The variability may be related to the outcome of the mitral valve repair.