Double jeopardy in the echocardiography laboratory: coexistence of two distinct cardiomyopathies?

BACKGROUND: In our Hypertrophic Cardiomyopathy (HCM) Center, we identified 6 patients each with what appeared to be the occurrence of 2 rare diseases that prompted investigation for a common derivative. METHODS: We reviewed our database, searching for all patients with a diagnosis of HCM, amyloid heart disease and left ventricular noncompaction (LVNC). RESULTS: Using transthoracic echocardiography and magnetic resonance imaging, we identified 6 patients with apical hypertrabeculations and myocardium suggestive of LVNC; 4 of the patients had HCM and 2 of the patients had cardiac amyloidosis. CONCLUSIONS: The significance of these possible concomitant cardiomyopathies is not presently well understood. We did not identify a common derivative when looking for a genetic link, but it is most likely hidden in the genetic substrate, yet to be identified

Myocardial mechanics: understanding and applying three-dimensional speckle tracking echocardiography in clinical practice

Speckle tracking echocardiography (STE) is an emerging tool to characterize and quantify myocardial segmental and rotational mechanics. This literature review is aimed at clinical and academic cardiologists to provide: (1) a conceptual framework of STE to initiate understanding of myocardial mechanics; (2) evidence that three-dimensional (3D) STE overcomes the problems of time-consuming data acquisition and postprocessing seen with two-dimensional STE; and (3) illustrative clinical cases with analysis of myocardial mechanics via 3D STE to show the incremental value of strain in clinical decision making