In 19 male patients with significant but minimally symptomatic or asymptomatic chronic aortic regurgitation, measurements of left ventricular shape, volume, and mass were assessed by cross-sectional echocardiography. End-diastolic volume and mass were significantly larger than normal values. There was a significant negative correlation between the volume-to-mass ratio (V/M) and both the end-diastolic (r = -0.70, p less than 0.01) and end-systolic (r = -0.73, p less than 0.001) long axis-to-minor diameter ratios (L/D), suggesting that maintenance of the normal geometry of the left ventricle is in part dependent on the adequacy of hypertrophy, as expressed by a normal V/M. Since preoperative volume-to-mass indices have been shown to be important predictors of postoperative course, the L/D ratio should be a useful and simple parameter to follow in asymptomatic patients.