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Figure 1 Left ventricular rotation (LVrot) at apical and basal levels during systole by "overlaid" speckle tracking images. End-systolic speckle tracking imaging acquisitions are overlaid on the end-diastolic image with corresponding local trajectories (tail and head of arrows indicate the location of end-diastole and end-systole). The LVrot was estimated from all of these regional angle displacements. Normally, at apical level, the left ventricle rotates counterclockwise as viewed from apex, whereas the base rotates clockwise, as in this representative case. This gradient of LVrot between the two levels creates a "wringing" motion of the left ventricle. Videos of speckle tracking imaging in apical and basal short-axis views are available at www.onlinejacc.org.
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