Abstract: AIM:To probe into the clinical value of velocity vector imaging (VVI) in measuring left ventricular twist (LVtw) in patients with primary hypertension. METHODS: Systolic and diastolic heart wall motion on a basal and on an apical level of the myocardium were examined in 68 patients with primary hypertension and 28 age-matched healthy controls using color Dopple echocardiography. Based on Ganau, patients with primary hypertension were divided into three groups: normal geometry (20 cases), concentric hypertrophy (23 cases) and eccentric hypertrophy (25 cases). LVtw and untwist were defined as apical rotation (rotation rate) relative to the basal level. RESULTS: Compared with controls, peak LV untwist velocity in patients with hypertension increased, the time to peak untwist velocity was prolonged, and the % isovolumic untwist decreased (P<0.05). Peak LVtw was significantly higher in patients with concentric hypertrophy and normal geometry compared with controls (P<0.05, P<0.01). Peak LVtw was significantly shorter in patients with eccentric hypertrophy compared with controls (P<0.01). Significant correlation was found between LVtw and LVEF (r=0.65, P<0.05). CONCLUSION: VVI is a reliable and noninvasive approach to measuring left ventricular torsional deformation and to evaluate early changes of heart function.