Apical ‘sparing’ pattern: This is a finding that its helpful in addition to others. Apical ‘sparing’ pattern: This is a finding that its helpful in addition to others. The left ventricle apical contractility may be preserved quite commonly in patients with advanced cardiac amyloidosis and can be depicted in a polar map of global longitudinal strain (A). There are other causes of apical ‘sparing’ such as aortic stenosis, hypertension, hypertrophic cardiomyopathy and variant of stress-induced cardiomyopathy. Notice how the basal segments do not contract as robustly as the apex (B, C). Ali M Agha et al. Open Heart 2018;5:e000881 ©2018 by British Cardiovascular Society