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Legend. Apical 2D echo and endomyocardial biopsy from Fabry’s disease (A,D) and hypertrophic cardiomyopathy (C,F). A binary appearance of endocardial border in the Fabry’s echocardiogram reflects the glycosphingolipid thickened endocardium (End) with engulfed smooth muscle cells (SMCs), a subendocardial empty space (SES), and a partially spared middle layer (ML). See page 1667.