A better indicator of filling volumes is the EDV. Kissing paps or low end- systolic volume is associated with decreased afterload and/or hyperdynamic state. If EDV is high and the paps are kissing that means that the afterload is low or there is a hyperdynamic state. If your EDV is low, you are more likely to have kissing papillaries because you start the contraction with low volumes.
due to mitral valve prolapse and flail