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Twenty-three patients, 15 of whom had clinical and electrocardiographic evidence of previous myocardial infarction, were studied by coronary arteriography and biplane angiocardiography. End-diastolic volume ranged from 55 to 317 ml/m 2 , left ventricular mass from 83 to 294 g/m 2 and ejection fraction from 0.13 to 0.75. An increased enddiastolic volume was associated with an increased left ventricular mass (r = 0.77, P < 0.01). In 15 of the 23 patients mitral regurgitant volume ranged from 0.7 to 4.7 L/min/m 2 and an end-diastolic volume greater than 154 ml/m 2 was associated with mitral regurgitation. The ejection fraction was significantly reduced in the absence as well as the presence of mitral regurgitation. These observations on coronary artery disease in 23 patients with refractory angina pectoris or persistent congestive heart failure, or both, reveal that in this group of patients (1) a dilated left ventricle was hypertrophied and the extent of hypertrophy was proportional to the dilatation; (2) an enlarged left ventricle was frequently associated with mitral regurgitation; and (3) dilatation, hypertrophy, and mitral regurgitation were interpreted as manifestations of reduced left ventricular performance.

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