Isovolumetric and auxotonic contractility parameters were analyzed at rest and following leg raising in 16 patients with predominantly congestive cardiomyopathy. Regional ventricular function was calculated using the hemiaxis method. In patients with mild cardiomyopathy, ventricular function improved following leg raising with an increase in the mean velocity of circumferential fiber shortening and a decrease in endsystolic volume. By contrast, patients with moderate and severe cardiomyopathy displayed deterioration of ventricular function with increased hypokinesia, particularly in the anterior and apical region. Endsystolic volume increased; mean velocity of circumferential fiber shortening, regional wall velocity, and ejection fraction decreased. These results suggest that in the early phase regional disturbances of ventricular function may regress in response to passive leg raising. In the severe forms of cardiomyopathy, the preexisting regional or generalized hypokinesia increased markedly following leg raising, reflecting limited or absent left ventricular contractility reserve.