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The apical mechanics is the result of the interaction between the subepicardial (ascendant) and the subendocardial (descendant) segments. Because of its larger radius, the ascendant segment overpowers the descent segment leading to a counterclockwise apical rotation and the smaller clockwise basal rotation. Practically, LV twist is calculated as the difference between the maximal rotation (positive) during systole of the apex and the maximal (negative) systolic rotation of the base
