In echocardiography, what is assessed primarily in cases of severe mitral regurgitation?

In cases of severe mitral regurgitation, the primary assessment focuses on left ventricular function. This is crucial because mitral regurgitation leads to volume overload in the left atrium and subsequently the left ventricle. As blood flows backward from the left ventricle into the left atrium during systole, the left ventricle compensates for this volume overload by dilating and eventually hypertrophying. Evaluating the left ventricular function helps to determine the extent of myocardial impairment and is essential for assessing the need for surgical intervention, such as mitral valve repair or replacement.

In the context of severe mitral regurgitation, while left atrial volume can also be indicative of the condition, it is primarily the function of the left ventricle that dictates the clinical management and outcomes. Pulmonary function is often affected as a secondary consequence due to increased left atrial pressures leading to pulmonary congestion, and right ventricular function may be assessed in heart failure stages, but they are not the primary focus when evaluating the severity of mitral regurgitation directly.