Hemodynamics in ruptured chordae tendineae and chronic rheumatic mitral regurgitation.

Twenty-five patients with proven ruptured mitral chordae tendineae and 25 patients with chronic rheumatic mitral regurgitation were studied with quantitative biplane left-heart angiocardiography. Compared to the rheumatic patients, the ruptured chordae group had strikingly smaller left atrial maximum volume (mean: 119 + 47 vs 267 + 131 mI/M2 mean) and less compliant left atrium (mean: 1.61 1.52 vs 5.14 + 4.31 ml/mm Hg-M2); less impressively but significantly smaller left ventricular end-diastolic volume (mean: 142 43 vs 188 + 75 mI/M2) and mass (mean: 133 27 vs 166 4 50 mMi/m2), and relatively insignificant tendency toward smaller left ventricular stroke volume and regurgitant flow per stroke. Ejection fractions, ventricular pressures, and forward flow per stroke were not significantly different. Within the ruptured chordae