The characteristics of left ventricular (LV) involvement in 31 patients with right ventricular cardiomyopathy (RVCMP) were studied by two-dimensional echocardiography (2D echo). Two groups were identified: in group 1 (19 patients) the LV appeared normal initially, but became abnormal in four patients during follow-up. LV involvement was present at diagnosis in the 12 patients of group 2; LV function worsened in one of them. In conclusion, LV involvement is frequent in RVCMP. At least in some cases the disease appears to be progressive.