{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T23:20:37Z","timestamp":1769469637804,"version":"3.49.0"},"reference-count":39,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Miami Heart Research Institute\/Florida Heart Research Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Cardiac rehabilitation (CR) and mechanics are individually associated with cardiovascular outcomes in ischemic heart disease (IHD); however, their interaction remains less defined. We hypothesized that a 36-session CR program improves cardiac strain and torsional mechanics in IHD patients. Methods: Ninety IHD patients on guideline-directed medical therapy with complete revascularization were prospectively enrolled, of which 27 electively completed a 36-session standardized exercise CR program. Speckle-tracking echocardiography was utilized to assess left ventricular (LV) global longitudinal strain (GLS) and peak twist, and right ventricular free wall strain (RVFWS) at baseline and after program completion. Participants were propensity-scoring matched 1:1 with 27 patients who declined participation (No-CR). Results: Clinical characteristics were similar between groups (mean age: 63 \u00b1 10 years, 82% male, 31% three-vessel coronary artery disease). When compared with baseline, the CR group experienced a significant improvement in LV GLS (\u221214.9 \u00b1 2.9 vs. \u221216.2 \u00b1 3.1%, p = 0.003), with a numerical but non-significant increase in peak LV twist (14.4 \u00b1 7.4 vs. 16.8 \u00b1 5.3\u00b0, p = 0.162). The No-CR group showed significant deterioration in RVFWS (\u221222.9 \u00b1 4.6% vs. \u221219.3 \u00b1 5.4%, p = 0.009), with no other changes including in GLS (\u221214.8 \u00b1 3.1 vs. \u221215 \u00b1 3.3%, p = 0.831). Follow-up comparisons between CR versus No-CR revealed significantly greater peak LV twist (16.8 \u00b1 5.3 vs. 12.1 \u00b1 4.2\u00b0, p = 0.001) and a healthier RVFWS (\u221222.2 \u00b1 4.5 vs. \u221219.3 \u00b1 5.4, p = 0.044) in CR participants. Conclusions: CR in patients with IHD improved LV GLS and, compared with No-CR, conferred better LV twist and RVFWS.<\/jats:p>","DOI":"10.3390\/jcdd13020062","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T12:41:16Z","timestamp":1769431276000},"page":"62","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Fitness on Cardiac Torsion and Wall Mechanics in Ischemic Heart Disease Study (FIT-TWIST)"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9445-7631","authenticated-orcid":false,"given":"Priscilla","family":"Wessly","sequence":"first","affiliation":[{"name":"Aurora Cardiovascular and Thoracic Services, Aurora Sinai\/Aurora St. Luke\u2019s Medical Centers, Milwaukee, WI 53215, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maiteder","family":"Larrauri Reyes","sequence":"additional","affiliation":[{"name":"Echocardiography & Non-Invasive Cardiovascular Laboratory, Division of Cardiology, Mount Sinai Medical Center, DeHirsch Meyer Tower 1st Floor, 4300 Alton Road, Miami Beach, FL 33140, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed I.","family":"Zaidi","sequence":"additional","affiliation":[{"name":"Orlando Health Heart and Vascular Institute, Orlando, FL 32714, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selin","family":"Sendil","sequence":"additional","affiliation":[{"name":"Echocardiography & Non-Invasive Cardiovascular Laboratory, Division of Cardiology, Mount Sinai Medical Center, DeHirsch Meyer Tower 1st Floor, 4300 Alton Road, Miami Beach, FL 33140, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarec K.","family":"Elajami","sequence":"additional","affiliation":[{"name":"Echocardiography & Non-Invasive Cardiovascular Laboratory, Division of Cardiology, Mount Sinai Medical Center, DeHirsch Meyer Tower 1st Floor, 4300 Alton Road, Miami Beach, FL 33140, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christos G.","family":"Mihos","sequence":"additional","affiliation":[{"name":"Echocardiography & Non-Invasive Cardiovascular Laboratory, Division of Cardiology, Mount Sinai Medical Center, DeHirsch Meyer Tower 1st Floor, 4300 Alton Road, Miami Beach, FL 33140, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"key":"ref_1","unstructured":"GBD 2021 Causes of Death Collaborators (2024). 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