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Figure 1 (A) Apical four-chamber view of a 66-year-old man. There is a thin epicardial layer (thin arrows) and an extremely thickened endocardial layer with prominent trabeculations and deep recesses (arrowheads). (B) Apical four-chamber view (end-diastolic still frame) of the same patient. There is blood flow from the ventricular cavity into the deep recesses visualized on color Doppler imaging. (C) Transsectional view from the anterior on the dorsal half of the heart of a 21-year-old man. There are both numerous trabeculations and deep recesses. Note marked fibroelastosis of the left ventricle. (D) Transmural, histologic section (hematoxylin and eosin stain). There are both an epicardial (compacted) layer (arrows) and an endocardial (noncompacted) layer. Note necrosis within the trabeculations (asterisks) as well as in the subendocardial area but not in the epicardial zone (arrowheads). LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle.
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