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To examine myocardial deformation and rotation in patients with heart failure, and elucidate the underlying mechanisms that account for normal ejection fraction (EF) in patients with diastolic heart failure (DHF).

Fifty consecutive patients presenting with congestive heart failure (age: 58 ± 16 years) underwent simultaneous right heart catheterization and transthoracic echocardiography. Left ventricular (LV) volumes, mass, EF, meridional, and circumferential wall stress were measured in addition to haemodynamic measurements. 2-D speckle tracking was applied to measure longitudinal, radial, and circumferential strain and twist. Twist was reduced only in patients with systolic heart failure (SHF: 5 ± 2°, DHF: 13 ± 6°, control: 14 ± 5°, P < 0.001). Circumferential strain was not different between DHF (−15 ± 5%) and control groups (−20 ± 3%, P > 0.05 …