Evaluation of left ventricular function using left ventricular twist and torsion parameters.

The left ventricular (LV) twist/torsion, wringing motion of the heart is a key element for regulating LV systolic and diastolic mechanics. Until recently, the evaluation of LV twist was limited to the research arena because of the requirement of invasive techniques or low availability of tagged MRI. The recent development of two-dimensional speckle tracking echocardiography enables the noninvasive measurement of LV rotation in humans. This article constitutes a practical guide for the measurement and interpretation of LV twist parameters using two-dimensional speckle tracking echocardiography and discusses its clinical usefulness for the evaluation of LV function.