Panagiotis Antiochos, Yin Ge, Michael Jerosch-Herold, Louis-Philippe David, Bobak Heydari, Paul Kolm, Dong-Yun Kim, Rob J van der Geest, Hugh Watkins, Milind Y Desai, Carolyn Y Ho, Sarahfaye F Dolman, Patrice Desvigne-Nickens, Martin S Maron, Jeanette Schulz-Menger, Stefan K Piechnik, Evan Appelbaum, William S Weintraub, Stefan Neubauer, Christopher M Kramer, Raymond Y Kwong
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We aimed to investigate the associations of entropy with risk predictors in HCM, using the National Heart, Lung, and Blood Institute HCM Registry.</p><p><strong>Methods: </strong>Entropy values were calculated using the probability distribution of pixel signal intensities of the left ventricular (LV) myocardium on the late gadolinium enhancement (LGE) short-axis stack images. Entropy values were correlated with demographic, genetic, imaging, and serum biomarkers as well as ambulatory Holter recordings and the European Society of Cardiology risk score of sudden cardiac death at 5 years.</p><p><strong>Results: </strong>Among 1736 patients with HCM, LV entropy demonstrated significant associations with sarcomere mutations, history of ventricular tachycardia, atrial fibrillation, and elevation of cTnT (cardiac troponin T) and NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels (<i>P</i><0.001). Furthermore, LV entropy demonstrated an association with increased maximal LV wall thickness, LGE presence and extent, higher extracellular volume, left atrial area and function, myocardial strain (<i>P</i><0.001), and was positively correlated with higher values of the European Society of Cardiology risk score (<i>P</i><0.001). In the subgroup of patients without LGE (n=858), entropy values remained significantly associated with a history of ventricular tachycardia, increased maximal wall thickness, decreased myocardial strain, and the European Society of Cardiology risk score (<i>P</i><0.05 for all). In both the whole cohort and in patients without LGE, LV entropy was the strongest predictor of ventricular tachycardia on Holter.</p><p><strong>Conclusions: </strong>In patients with HCM, LV entropy demonstrated associations with clinical, imaging, and biological predictors of adverse outcomes independent of LGE presence and was the strongest predictor of ventricular tachycardia on Holter.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT01915615.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018031"},"PeriodicalIF":7.0000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Myocardial Entropy and Risk Predictors in Hypertrophic Cardiomyopathy: An Analysis From the NHLBI HCM Registry.\",\"authors\":\"Panagiotis Antiochos, Yin Ge, Michael Jerosch-Herold, Louis-Philippe David, Bobak Heydari, Paul Kolm, Dong-Yun Kim, Rob J van der Geest, Hugh Watkins, Milind Y Desai, Carolyn Y Ho, Sarahfaye F Dolman, Patrice Desvigne-Nickens, Martin S Maron, Jeanette Schulz-Menger, Stefan K Piechnik, Evan Appelbaum, William S Weintraub, Stefan Neubauer, Christopher M Kramer, Raymond Y Kwong\",\"doi\":\"10.1161/CIRCIMAGING.125.018031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Entropy, a novel measure of myocardial tissue heterogeneity by cardiovascular magnetic resonance imaging, may have clinical value in patients with hypertrophic cardiomyopathy (HCM). We aimed to investigate the associations of entropy with risk predictors in HCM, using the National Heart, Lung, and Blood Institute HCM Registry.</p><p><strong>Methods: </strong>Entropy values were calculated using the probability distribution of pixel signal intensities of the left ventricular (LV) myocardium on the late gadolinium enhancement (LGE) short-axis stack images. Entropy values were correlated with demographic, genetic, imaging, and serum biomarkers as well as ambulatory Holter recordings and the European Society of Cardiology risk score of sudden cardiac death at 5 years.</p><p><strong>Results: </strong>Among 1736 patients with HCM, LV entropy demonstrated significant associations with sarcomere mutations, history of ventricular tachycardia, atrial fibrillation, and elevation of cTnT (cardiac troponin T) and NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels (<i>P</i><0.001). Furthermore, LV entropy demonstrated an association with increased maximal LV wall thickness, LGE presence and extent, higher extracellular volume, left atrial area and function, myocardial strain (<i>P</i><0.001), and was positively correlated with higher values of the European Society of Cardiology risk score (<i>P</i><0.001). In the subgroup of patients without LGE (n=858), entropy values remained significantly associated with a history of ventricular tachycardia, increased maximal wall thickness, decreased myocardial strain, and the European Society of Cardiology risk score (<i>P</i><0.05 for all). 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Myocardial Entropy and Risk Predictors in Hypertrophic Cardiomyopathy: An Analysis From the NHLBI HCM Registry.
Background: Entropy, a novel measure of myocardial tissue heterogeneity by cardiovascular magnetic resonance imaging, may have clinical value in patients with hypertrophic cardiomyopathy (HCM). We aimed to investigate the associations of entropy with risk predictors in HCM, using the National Heart, Lung, and Blood Institute HCM Registry.
Methods: Entropy values were calculated using the probability distribution of pixel signal intensities of the left ventricular (LV) myocardium on the late gadolinium enhancement (LGE) short-axis stack images. Entropy values were correlated with demographic, genetic, imaging, and serum biomarkers as well as ambulatory Holter recordings and the European Society of Cardiology risk score of sudden cardiac death at 5 years.
Results: Among 1736 patients with HCM, LV entropy demonstrated significant associations with sarcomere mutations, history of ventricular tachycardia, atrial fibrillation, and elevation of cTnT (cardiac troponin T) and NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels (P<0.001). Furthermore, LV entropy demonstrated an association with increased maximal LV wall thickness, LGE presence and extent, higher extracellular volume, left atrial area and function, myocardial strain (P<0.001), and was positively correlated with higher values of the European Society of Cardiology risk score (P<0.001). In the subgroup of patients without LGE (n=858), entropy values remained significantly associated with a history of ventricular tachycardia, increased maximal wall thickness, decreased myocardial strain, and the European Society of Cardiology risk score (P<0.05 for all). In both the whole cohort and in patients without LGE, LV entropy was the strongest predictor of ventricular tachycardia on Holter.
Conclusions: In patients with HCM, LV entropy demonstrated associations with clinical, imaging, and biological predictors of adverse outcomes independent of LGE presence and was the strongest predictor of ventricular tachycardia on Holter.
期刊介绍：
Circulation: Cardiovascular Imaging, an American Heart Association journal, publishes high-quality, patient-centric articles focusing on observational studies, clinical trials, and advances in applied (translational) research. The journal features innovative, multimodality approaches to the diagnosis and risk stratification of cardiovascular disease. Modalities covered include echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging and spectroscopy, magnetic resonance angiography, cardiac positron emission tomography, noninvasive assessment of vascular and endothelial function, radionuclide imaging, molecular imaging, and others.
Article types considered by Circulation: Cardiovascular Imaging include Original Research, Research Letters, Advances in Cardiovascular Imaging, Clinical Implications of Molecular Imaging Research, How to Use Imaging, Translating Novel Imaging Technologies into Clinical Applications, and Cardiovascular Images.
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