CONCLUSION

This study demonstrates that strain echocardiography provides valuable additional information for assessing myocardial function in cats with HCM phenotypes. Key findings include significantly reduced LVGLS and LARS in cats with hypertrophic phenotype and LA enlargement compared with healthy controls, while RVLS remained relatively preserved. Strain–volume curve analysis revealed impaired myocardial deformation patterns, characterized by flatter, right-shifted curves in affected cats, despite preserved conventional systolic indices such as FS. These results highlight the complementary value of multi-chamber strain parameters in detecting subclinical dysfunction and differentiating hypertrophic phenotypes.

The integration of LVGLS, RVLS, and LARS into routine echocardiographic evaluation can improve early detection of myocardial dysfunction, enhance phenotypic characterization, and support more accurate disease staging in feline HCM. This approach may assist clinicians in identifying cats at higher risk of progression and guide therapeutic decisions, ultimately contributing to better management of this common cardiac disease.

The study employed a comprehensive multi-chamber strain analysis combined with strain–volume curve evaluation, providing a more complete assessment of cardiac mechanics than previous investigations focused on single chambers. The use of standardized imaging protocols and offline analysis with vendor-specific software ensured high reproducibility.

The study was conducted at a single center with a relatively small sample size. Some cats were excluded due to suboptimal image quality and elevated heart rates, reflecting the technical challenges associated with feline patients. Additionally, threshold values for feline LALS remain to be standardized across platforms and populations. Circulating cardiac biomarkers, such as NT-proBNP, were not evaluated.

Larger, multicenter studies are warranted to validate diagnostic cut-offs and prognostic implications of these strain parameters. Future research should incorporate longitudinal follow-up to assess the predictive value of strain indices for clinical outcomes and to evaluate the combined use of STE with cardiac biomarkers to improve detection of early myocardial dysfunction in cats.

In conclusion, multi-chamber strain echocardiography integrating LVGLS, RVLS, and LARS, together with strain–volume curve analysis, offers a sensitive and comprehensive tool for evaluating myocardial mechanics in cats with HCM. This approach enhances diagnostic precision beyond conventional echocardiography and holds promise for improving early detection, risk stratification, and clinical management of feline cardiomyopathy.