Background: The relation between remodeling and left ventricular (LV) torsion has not yet been fully investigated. The aim of this study was to determine whether LV torsion assessed by speckle tracking imaging may predict progressive LV dilation after acute myocardial infarction (AMI). Methods: From January 2006 through June 2008, 95 patients with AMI who successfully treated with primary coronary intervention underwent conventional and speckle tracking echocardiography at initial presentation, 3 days and 6 months after the index infarction. Patients were divided into two groups according to LV remodeling after 6 months follow up. LV remodeling was defined that end-diastolic volume increased above 20%. Results: LV remodeling was developed in 26 patients. Before reperfusion therapy, LV torsion was significantly reduced for remodeling group (1.7 짹 0.5 deg/cm). During serial follow-up, LV torsion did not recovery in remodeling group (figure). According to receiver operating characteristic analysis, LV torsion ��� 1.8 deg/cm (AUC = 0.78, sensitivity = 82.3 %, specificity = 67.7 %) at initial presentation was selected as significant predictor of remodeling. Conclusions: These data suggest that early estimation of LV torsion provides a simple and accurate mean to predict late LV dilation after reperfused AMI.