The Prognostic Value of Left Ventricular Entropy From T1 Mapping in Patients With Hypertrophic Cardiomyopathy

Jie Wang; Jinquan Zhang; Lutong Pu; Weitang Qi; Yuanwei Xu; Ke Wan; Yanjie Zhu; Georgios V Gkoutos; Yuchi Han; Yucheng Chen

doi:10.1016/j.jacasi.2024.01.005

The Prognostic Value of Left Ventricular Entropy From T1 Mapping in Patients With Hypertrophic Cardiomyopathy

JACC Asia. 2024 Mar 26;4(5):389-399. doi: 10.1016/j.jacasi.2024.01.005. eCollection 2024 May.

Authors

Jie Wang^{1

2}, Jinquan Zhang³, Lutong Pu¹, Weitang Qi¹, Yuanwei Xu¹, Ke Wan⁴, Yanjie Zhu⁵, Georgios V Gkoutos^{2

6

7}, Yuchi Han⁸, Yucheng Chen^{1

9}

Affiliations

¹ Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
² College of Medical and Dental Sciences, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom.
³ Division of Informatics, Imaging & Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
⁴ Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
⁵ Paul C. Lauterbur Research Centre for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
⁶ Institute of Translational Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
⁷ Health Data Research UK (HDR), Midlands Site, Birmingham, United Kingdom.
⁸ Cardiovascular Division, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA.
⁹ Center of Rare Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Abstract

Background: The prognostic value of left ventricular (LV) entropy in hypertrophic cardiomyopathy (HCM) is unclear.

Objectives: This study aimed to assess the prognostic value of LV entropy from T1 mapping in HCM.

Methods: A total of 748 participants with HCM, who underwent cardiovascular magnetic resonance (CMR), were consecutively enrolled. LV entropy was quantified by native T1 mapping. A competing risk analysis and a Cox proportional hazards regression analysis were performed to identify potential associations of LV entropy with sudden cardiac death (SCD) and cardiovascular death (CVD), respectively.

Results: A total of 40 patients with HCM experienced SCD, and 65 experienced CVD during a median follow-up of 43 months. Participants with increased LV entropy (≥4.06) were more likely to experience SCD and CVD (all P < 0.05) in the entire study cohort or the subgroup with low late gadolinium enhancement (LGE) extent (<15%). After adjustment for the European Society of Cardiology predictors and the presence of high LGE extent (≥15%), LV mean entropy was an independent predictor for SCD (HR: 1.03; all P < 0.05) by the multivariable competing risk analysis and CVD (HR: 1.06; 95% CI: 1.03-1.09; P < 0.001) by multivariable Cox regression analysis.

Conclusions: LV mean entropy derived from native T1 mapping, reflecting myocardial tissue heterogeneity, was an independent predictor of SCD and CVD in participants with HCM. (Cardiac Magnetic Resonance Imaging Clinical Application Registration Study; ChiCTR1900024094).

Keywords: T1 mapping; cardiac magnetic resonance; entropy; hypertrophic cardiomyopathy; sudden cardiac death.