Heart failure & cardiomyopathies
Myocardial Entropy and Risk Predictors in Hypertrophic Cardiomyopathy: An Analysis From the NHLBI Hypertrophic Cardiomyopathy (HCM) Registry
Authors' conclusion
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.
Study context
- Population
- Patients with HCM in the NHLBI HCM Registry
- Participants
- 1,736 patients
- Outcome
- Associations of LV entropy (CMR LGE images) with risk predictors in HCM
Methodological detailsregistry analysis
- Registry analysis
Main finding
As reported in the abstract
Associations of LV entropy with risk predictors
- Left ventricular (LV) entropy associated with sarcomere mutations, history of VT, AF, elevated cTnT and NT-proBNP
- P<0.001
- LV entropy associated with increased maximal LV wall thickness, late gadolinium enhancement (LGE) presence and extent, higher extracellular volume, left atrial area and function, myocardial strain
- P<0.001
- LV entropy positively correlated with higher ESC SCD risk score
- P<0.001
- LV entropy strongest predictor of VT on Holter, whole cohort: OR 1.59 (95% CI 1.33-1.90)
- P<0.001
Observational data: associations, not effects.
Further findings
Associations of LV entropy in patients without LGE (subgroup, n=858)
- Entropy associated with history of VT, increased maximal wall thickness, decreased myocardial strain and ESC risk score
- P < 0.05 for all
- LV entropy strongest predictor of VT on Holter: OR 1.87 (95% CI 1.28-2.74)
- P < 0.001
Original publication
Myocardial Entropy and Risk Predictors in Hypertrophic Cardiomyopathy: An Analysis From the NHLBI HCM Registry. Circ Cardiovasc Imaging. Published 24 September 2025. doi:10.
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