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In order to assess the influence of orally administered verapamil on left ventricular function, 12 anginal patients were studied using M-mode echocardiography prior to and following two weeks of treatment with verapamil, 120 mg t.i.d. Baseline measurements were obtained by averaging the three measurements from the three different echocardiographic recordings; measurements during treatment were obtained by averaging three measurements on a single recording. The following parameters were considered: end-diastolic (dD) and end-systolic diameters of the left ventricle, fractional shortening, peak ejection rate and peak filling rate. On baseline examination, the end-diastolic diameter was 52.3 +/- 7.9 mm, the end-systolic diameter was 32.4 +/- 7.2 mm, the fractional shortening was 38.5 +/- 5.2%, peak ejection rate was 2.46 +/- 0.41 and peak filling rate was 4.87 +/- 1.44 1/sec. After verapamil treatment the end-diastolic diameter was 54.5 +/- 8.1 mm and the end-systolic diameter was 34.0 +/- 6.6 mm: both parameters showed a significant increase (p less than 0.05 for both). Fractional shortening (37.9 +/- 4.8%), peak ejection rate (2.29 +/- 0.39 1/sec) and peak filling rate (4.94 +/- 1.64 1/sec) remained unchanged. Verapamil plasma level was 149 +/- 1076 ng/ml; there was no significant correlation with the percentage variations of the echocardiographic parameters. In conclusion, in patients with normal cardiac function, chronic treatment with verapamil does not affect ventricular performance. In fact, a slight but significant cardiac dilatation appears to be the mechanism adopted to maintain adequate cardiac performance.