Confused about mitral valve regurgitation

Normagal, Echo can underestimate leakage. Or something else might be causing the shortness of breath.
You might ask for a cardiac MRI. Or see a pulmonary specialist. You can have valve repair with moderate regurgitation, if it is the cause of your shortness of breath. You might return to this cardiologist with your concerns or have a consultation with a different (more aggressive?) cardiologist. The risks of surgery may be
informing your doctor that delaying surgery would be safer for you.
In your situation, I would pursue it partly because you are probably in better condition now for surgery that you would be in a year.
A cardiologist warned my father to have valve surgery within two years, but when he went back to get a referral, the doctor advised against it. In the time between Dad's two appointments, a friend that the doctor had advised to have knee surgery, died on the table from the anesthesia. Dad went on to have successful surgery.

Hi @normagal
Others mentioning mitral valve regurgitation and shortness of breath may have thoughts for you: @mitral, @mikena, @gerrycf, @dicooley

While you wait for others to comment you may find what Mayo Clinic summarizes helpful:
- Mayo Clinic Mitral Valve Regurgitation Overview
https://www.mayoclinic.org/diseases-conditions/mitral-valve-regurgitation/symptoms-causes/syc-20350178
I experience shortness of breath and have been learning figuring out why isn’t always a simple process. In fact, there may be more than one contributing factors.

You mention you have shortness of breath and some activities make you tired, all this along with learning moderate mitral valve regurgitation was found during a cardiac echo. What prompted getting an echo? It seems reasonable to pursue pulmonary testing to confirm why this is happening. Are your symptoms new Do you have shortness of breath when you exert yourself?