Objective To investigate whether left ventricular entropy based on MR-LGE image can predict the risk of major cardiac adverse events(MACE)in patients with hypertrophic cardiomyopathy(HCM).Methods Patients who met the diagnostic criteria of HCM and had cardiac magnetic resonance(CMR)examination from January 2018 to December 2021 were selected,with MACE as the endpoint event.According to the follow-up results,the patients were divided into the MACE group and the non-MACE group.The left ventricular ejection fraction(LVEF)was measured by CVI42 cardiac post-processing software,and the LGE image was imported into Python 3.8 software to obtain the left ventricular entropy.Re-sults A total of 107 HCM patients were included,with a median follow-up of 23 months,including 34 patients in the MACE group and 73 patients without MACE.The inner diameter of left atrium(LAD)in MACE group[(39.14±6.85)mm vs.(35.24±7.70)mm],maximum left ventricular Maximum wall thickness(LVMWT)[(21.18±4.37)vs.(19.23±3.11)],and left ventricular entropy[5.12(3.94,6.18)vs.4.04(2.64,5.45)]were higher than those without MACE(all P＜0.05);The LVEF of MACE group[(53.54±14.94)％vs.(59.64±10.95)％]was lower than that of non-MACE group(P=0.038).Single logistic regression showed that LAD,LVMWT,LVEF and left ventricular entropy were the risk factors for MACE.Further multi-factor regression showed that LVEF(OR=0.960,95％CI:0.927-0.995,P=0.026)and left ventricular entropy(OR=1.600,95％CI:1.148-2.229,P=0.006)were independent risk factors for MACE in HCM.Receiver Operating characteristic(ROC)curve showed that the area under the curve(AUC)of LVEF uni-variate prediction model was 0.637,the optimal cut-off value was 52.41％,the sensitivity was 41.18％,and the specificity was 84.93％.The AUC of the single variable prediction model of left ventricular entropy was 0.692,the optimal cut-off val-ue was 4.975,the sensitivity was 61.76％,and the specificity was 71.23％.The AUC of the combined prediction model of left ventricular entropy and LVEF was 0.721.Conclusion Left ventricular entropy based on CMR-LGE image can reflect myocardial heterogeneity and is an effective predictor of prognosis in HCM patients.The risk of MACE in HCM patients in-creases with the increase of left ventricular entropy,which is helpful to provide a more comprehensive risk stratification for HCM patients and improve the prognosis of patients.
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