Echocardiographic Features of Cardiomyopathies: A Comprehensive Review

Figures

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  FIGURE 1. Major cardiomyopathies and their main echocardiographic features. (A) Dilated CMP: thin myocardium and dilated LV with low function. (B) Hypertrophic CMP: thick myocardium. (C) Restrictive CMP: significantly dilated atria. (D) Arrhythmogenic RV CMP: dilated RV. (E) Non‐compaction CMP: spongiform myocardium.

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  FIGURE 2. Measurement of left ventricular end‐diastolic diameter (LVEDD). (A) M‐mode echocardiogram showing LVEDD as the maximal internal dimension of the left ventricle during diastole. (B) 2D parasternal long‐axis view demonstrating the same measurement with directional annotation.

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  FIGURE 3. RV diameters used to quantify the RV size and remodeling conditions.

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  FIGURE 4. Echocardiographic variants of HCM. (A) Asymmetric septal hypertrophy with a reverse curvature of the interventricular septum. (B) Symmetric septal hypertrophy with a neutral septal contour. (C) Sigmoid‐shaped septal hypertrophy localized to the basal portion of the septum. (D) Apical hypertrophy limited to the apex, with normal wall thickness in the basal segments.

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  FIGURE 5. M‐mode echocardiogram demonstrating systolic anterior motion (SAM) of the mitral valve. The image captures the characteristic anterior displacement of the mitral valve leaflet during systole, indicative of hypertrophic obstructive cardiomyopathy (HOCM). The arrow marks the point of maximal anterior motion toward the interventricular septum, contributing to dynamic left ventricular outflow tract (LVOT) obstruction.

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  FIGURE 6. Doppler echocardiographic image demonstrating dynamic left ventricular outflow tract (LVOT) obstruction highlighting a turbulent jet (red arrow) consistent with systolic anterior motion (SAM) of the mitral valve and LVOT obstruction.

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  FIGURE 7. Doppler echocardiographic findings consistent with restrictive cardiomyopathy: markedly elevated early diastolic (E) velocity (126 cm/s), a diminished atrial (A) velocity (33 cm/s), an E/A ratio of 3.8, and a shortened deceleration time (DT) of 104 ms.

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  FIGURE 8. Tissue Doppler imaging (TDI) of the mitral annulus in restrictive cardiomyopathy. The spectral TDI tracing demonstrates a markedly reduced early diastolic mitral annular velocity (e′) and a relatively preserved atrial velocity (a′), consistent with impaired myocardial relaxation. The calculated E/e′ ratio is elevated (18), indicating elevated left ventricular filling pressures, a hallmark of restrictive physiology.

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  FIGURE 9. M‐mode echocardiographic image demonstrating dilated inferior vena cava (IVC) with blunted respiratory variation in restrictive cardiomyopathy. The top panel shows a 2D subcostal view of the IVC entering the right atrium. The lower M‐mode tracing illustrates persistently dilated IVC diameter with minimal inspiratory collapse, as shown by the near‐parallel motion of the IVC walls. This finding is consistent with elevated right atrial pressures and impaired ventricular compliance, typical of restrictive physiology.

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  FIGURE 10. A subcostal echocardiographic image suggestive of arrhythmogenic right ventricular cardiomyopathy (ARVC). This parasternal long‐axis view demonstrates a dilated and hypokinetic right ventricle (RV) with irregular endocardial contours, while the left ventricle (LV) appears structurally normal. The arrow highlights regional RV wall thinning and dyskinesia, which are characteristic findings in ARVC. This structural abnormality, combined with clinical and ECG criteria, supports the diagnosis of ARVC.

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  FIGURE 11. Apical short axis view of LV showing >2 ratio of non‐compacted to compact myocardium. This finding (Jennie criteria) should be added to other criteria to diagnose LVNC cardiomyopathy.