To determine the relationship between functional classes (NYHA) and hemodynamics in patients (pts) with chronic aortic insufficiency, indices of left ventricular (LV) function derived from hemodynamic and biplane left cineventriculographic data were compared with the clinical status in 51 AI pts, including 15 pts in class I, 26 pts in class II and 10 pts in class III. Regurgitant fraction (0.55 +/- 0.15 mean +/- SD), cardiac index (3.1 +/- 0.7 l/mn/m2) and LV end-diastolic pressure (14 +/- 7 mmHg) were of the same order of magnitude in 3 classes patients. A significant correlation was evidenced between functional classes and 1/LV ejection fraction (0.53 +/- 0.13, 0.50 +/- 0.39, 0.42 +/- 0.17 in class I, II, III pts, respectively, p less than 0.04), 2/LV end-systolic volume (88 +/- 48, 90 +/- 31, 138 +/- 68 ml/m2 in class I, II and III pts, respectively p less than 0.02), 3/ and LV mass (168 +/- 57, 204 +/- 94, 291 +/- 128 g/m2 in class I, II and III pts respectively, p less than 0.003). Only the latter parameter could discriminate symptomatic from asymptomatic AI pts.