Figure 3

Two-dimensional transthoracic echocardiogram recorded in the marginal recipient with cardiac amyloid. In both the parasternal long-axis (right) and apical four-chamber (left) images note the homogeneous echo intensity of the myocardium, which is noted as a bright "speckling" appearance. Both the mitral and aortic valves are also thickened. The patient had severe ventricular dysfunction and advanced heart failure symptoms (NYHA Class IV). (Images from Marinella Ferlito, Director Echo lab, and Prof Claudio Rapezzi, University Cardiology Division, S. Orsola Hospital, Bologna, Italy) Additional files (video clips) 5 and 6. Two-dimensional transthoracic echocardiogram of the donor heart grafted in the marginal recipient. In both the parasternal long-axis (Additional file 5) and apical four-chamber (Additional file 6) views note the excellent global and regional ventricular function. Chambers and cardiac structures are normals. (Images from Marinella Ferlito, Director Echo lab, and Prof Claudio Rapezzi, University Cardiology Division, S. Orsola Hospital, Bologna, Italy)