What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertrophic cardiomyopathy (n=280). Intervention: 2-dimensional and M-mode echocardiography vs. Different imaging views and modes. Primary outcome: Agreement between different imaging views and modes for assessing left ventricular wall thickness (p=<.001).

What question did this study set out to answer?

This research aims to assess the agreement between various echocardiographic methods for measuring left ventricular wall thickness in cats, particularly in those with hypertrophic cardiomyopathy.

April 13, 2026Open Access

Effect of echocardiographic imaging view and methods on left ventricular wall-thickness measurements in normal cats and cats with hypertrophic cardiomyopathy

Q: What are the key findings of this study?

Two-dimensional and M-mode echocardiographic methods for assessing left ventricular wall thickness cannot be used interchangeably, particularly in cats with hypertrophic cardiomyopathy (P < .001).

Q: What question did this study set out to answer?

This research aims to assess the agreement between various echocardiographic methods for measuring left ventricular wall thickness in cats, particularly in those with hypertrophic cardiomyopathy.

Key Result

Two-dimensional and M-mode echocardiographic methods for assessing left ventricular wall thickness cannot be used interchangeably, particularly in cats with hypertrophic cardiomyopathy (P < .001).

Key Points

This research aims to assess the agreement between various echocardiographic methods for measuring left ventricular wall thickness in cats, particularly in those with hypertrophic cardiomyopathy.
Retrospective, single-center, cross-sectional study design
Measured left ventricular free wall and interventricular septum thickness using 2D and M-mode echocardiography
Utilized different imaging views: right parasternal long-axis and right parasternal short-axis
Compared measurement methods using repeated measurement ANOVA and Bland–Altman analysis
In control cats, no significant differences in IVS thickness among the four methods (P = .67)
LVFW thickness differed significantly between M-mode and 2D methods (P < .001)
In HCM cats, significant differences in IVS and LVFW thickness were found among methods (P < .001)

Study Design

Type

Cross-Sectional (n=280)

Multicenter

Structured PICO

Does the choice of echocardiographic imaging view and mode affect left ventricular wall-thickness measurements in normal cats and cats with hypertrophic cardiomyopathy?

Population

280 cats; 140 controls and 140 with subclinical hypertrophic cardiomyopathy (HCM)

Intervention

Echocardiographic assessment using 4 methods: right parasternal long-axis (RPLax) using 2D (M1), RPLax using M-mode (M2), right parasternal short-axis (RPSax) using 2D (M3), and RPSax using M-mode (M4)

Comparator

Comparison among the 4 echocardiographic methods

Outcome

Agreement between methods for end-diastolic interventricular septum (IVS) and left ventricular free wall (LVFW) thicknesssurrogate

Two-dimensional and M-mode echocardiographic methods yield significantly different measurements of left ventricular wall thickness in cats with HCM and cannot be used interchangeably.

Main Result

p-value: p=<.001

Abstract

Abstract Background Echocardiographic measurements of left ventricular free wall (LVFW) and interventricular septum (IVS) thickness are essential for diagnosing hypertrophic cardiomyopathy (HCM). Hypothesis/Objectives To evaluate agreement between different imaging views and modes for assessing LV wall thickness in cats. We hypothesized that there is clinically relevant bias between methods, and that results cannot be used interchangeably. Animals Two-hundred eighty cats; 140 controls and 140 with subclinical HCM. Methods Retrospective, single-center, and cross-sectional study. End-diastolic IVS and LVFW thickness was evaluated by 2-dimensional (2D) and time-motion mode (M-mode) echocardiography, from right parasternal long-axis (RPLax) and right parasternal short-axis (RPSax) views: method-1 (M1), RPLax using 2D; M2, RPLax using M-mode; M3, RPSax using 2D; and M4, RPSax using M-mode. Using 2D images, the thickest portion of the LV wall was measured. Methods were compared using repeated measurement ANOVA on ranks and the Bland–Altman method with bias and 95% limits of agreement (95% LOA). Results In controls, IVS thickness was not different among the 4 methods (P = .67; bias 0.04-0.10 mm, 95% LOA −1.09 to 1.28 mm); whereas LVFW thickness was (P .001) using M-mode compared to 2D (bias 0.22-0.30 mm; 95% LOA −0.81 to 1.25 mm). In HCM cats, thickness of the IVS (bias −1.07 to −1.13 mm; 95% LOA −3.05 to 0.84 mm) and LVFW (bias 0.22 to −.27 mm; 95% LOA −2.09 to 2.03 mm) was different among methods (P .001). Conclusions and clinical importance Two-dimensional and M-mode echocardiographic methods in the assessment of LV wall thickness cannot be used interchangeably, particularly in cats with HCM.