Chordae tendineae

The chordae tendineae are collagen-rich tensile cords connecting valve leaflets of the mitral valve and tricuspid valve to papillary muscles. Their tension helps restrain the leaflets against displacement toward an atrium during ventricular systole. They are supports for pressure-loaded leaflets, rather than muscles that pull the valves open. The aortic valve and pulmonary valve do not have this chordal apparatus.^[ref]

An original static model shows why the arrangement matters. Suppose a leaflet attachment experiences a resultant force $F=\Delta pA$ from a pressure difference $\Delta p$ acting over effective area $A$. Two equal tethers each carry tension $T$ at angle $\theta$ to the load axis. Their transverse components cancel and their axial components balance the load:A stipulated $\Delta p=10$ kPa over $A=1$ cm${}^2$ gives $F=1$ N. Changing $\theta$ from $30^{\circ }$ to $60^{\circ }$ raises each tether's tension from about $0.577$ to $1$ N without changing the pressure load.

A primary experiment tested the related geometrical question in a left-heart simulator. Force transducers measured selected chordae tendineae while the positions of papillary muscles were changed. Different chordal types responded differently.^[ref] Real leaflets distribute loading among many attachments, so the two-tether model explains a mechanism without supplying a universal chordal force. Material behavior, geometry and the timing of ventricular contraction remain separate inputs.