For a study, the researchers sought to compare the level of agreement between speckle tracking echocardiography (STE) and feature tracking cardiovascular magnetic resonance (FT-CMR) in patients with hypertrophic cardiomyopathy (HC) and varying degrees of fibrosis as defined by late gadolinium enhancement to see how well they could relate to myocardial fibrosis. STE and CMR with late gadolinium enhancement and FT-CMR were performed on 79 patients with HC and 16 volunteers (control group) at 2 reference locations. Patients were categorized into 3 groups: those with no detectable fibrosis, those with mild fibrosis, and those with substantial fibrosis. FT-CMR and STE were used to calculate global longitudinal strain (GLS) and global radial strain (GRS). When compared to the control group, STE-derived GRS was lower in all HC categories (p<0.001), whereas FT-CMR GRS was lower only in patients with HC with fibrosis (p<0.05). Reduced STE-derived GLS was linked to extensive fibrosis (p<0.05), and a value of less than −15.2% indicated those with extensive fibrosis (sensitivity 79%, specificity 92%, area under the curve 0.863, 95% CI 0.76 to 0.97, p<0.001). For STE versus CMR-GLS (overall population intra-class correlation coefficient=0.615, 95% CI 0.42 to 0.75, p<0.001; patients with HC 0.63, 0.42 to 0.76, p<0.001) and GRS (overall population intra-class correlation coefficient=0.601, 95% CI 0.397 to 0.735, p<0.001), inter-modality agreement was moderate.  In patients with HC, there was a poor level of agreement for GRS between techniques. In conclusion, strain indexes determined by echocardiography and CMR in patients with HC were lower than in the control group and correspond well with the severity of myocardial fibrosis. Reduced STE-GLS could identify people with severe fibrosis, but it was unclear whether it was useful for risk stratification for sudden cardiac death.