Background Amyloidosis is a rare and heterogeneous disease condition caused by the accumulation of amyloid protein in particular organs. Cardiac amyloidosis is an underdiagnosed form of cardiomyopathy characterised by the accumulation of amyloid protein in the heart. AL amyloidosis is one of the two most common types of cardiac amyloid and refers to the accumulation of misfolded monoclonal immunoglobulin light chains. Cardiac involvement due to AL amyloidosis portends a poor prognosis. When screening for evidence of amyloid cardiomyopathy, transthoracic echocardiography (TTE) is the imaging method of choice for the initial screening. More recently, 2D speckle tracking echocardiography (2D-STE) strain has been established to aid in the early detection of cardiac involvement in amyloidosis. Aim The purpose of this thesis is to undertake detailed analyses of strain measurements using 2D-speckled tracking echocardiography and to establish whether specific characteristics, could be a valuable diagnostic tool, in the evaluation of AL cardiac amyloidosis. In more detail this thesis will investigate the detailed evaluation of multilayer and multi-segmental 2D-STE strain measurements and identify variations in strain parameters relative to conventional echocardiographic measures in patients with AL amyloidosis, hypertensive heart disease, and healthy controls. Methods TTE with 2D-speckled tracking echocardiography was performed on 75 patients with AL amyloidosis between August 2008 and June 2016 and compared to 49 patients with hypertensive heart disease and 49 healthy controls. Global multi-layer strain was obtained from the epicardial, midmyocardial, and endocardial layers from the apical long axis, 4-chamber, and 2-chamber views. In addition, segmental strain values were measured as the average of six basal, six mid, and six apical segments derived from mid-myocardial longitudinal strain. Circumferential and radial strain were measured utilising a parasternal short axis view at the mid-papillary level. Results Global longitudinal strain (GLS) was reduced in epicardial (-14.3±-4.0 vs -17.4 ± 2.2%vs. -17.5±-2.0%, p