To evaluate the effect of left ventricular (LV) distortion on its pump function, two-dimensional echocardiographic short axis views of the LV cavity were analyzed in 20 normal subjects (group N) and 9 patients with right ventricular pressure overloading (group PH). Functional significance of LV distortion was evaluated by the efficiency (E) of systolic shortening of endocardial circumferential fiber length (ECL) in reducing LV cavity area