Shown are the precordial long axis (panel A) and apical four-chamber views (panel B) from a patient with dilated cardiomyopathy. The long axis view demonstrates increased sphericity of the left ventricle (LV) and the long axis and short axis ratio approaches unity (normal 2:1). There is left atrial (LA) enlargment and a very large "residual" left ventricular end-systolic volume (ie, at end-systole there is a large unejected volume remaining in a dilated LV). The impression of increased sphericity is reinforced in the four-chamber view. In addition, there is also dilation of the right atrium (RA) and right ventricle (RV) four-chamber dilation, connoting a poor prognosis.