B-PO03-165 MEAN SCAR ENTROPY PREDICTS VENTRICULAR ARRHYTHMIAS EVENTS IN HYPERTROPHIC CARDIOMYOPATHY USING LATE GADOLINIUM ENHANCEMENT CARDIAC MAGNETIC RESONANCE

Abstract

Ventricular arrhythmias (VAs) is associated with sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM). Previous studies have found late gadolinium enhanced (LGE) on cardiac magnetic resonance (CMR)was independently associated with VAs in HCM. Risk stratification of VAs remains complex and LGE is present in the majority of HCM patients. This study was to determine whether the LGE by CMR derived entropy within the scar and the left ventricular (LV) myocardium predicts VAs in HCM. Consecutive HCM patients with scar by LGE-CMR were included. Routine left ventricular function parameters including LV ejection fraction (LVEF) and %LGE defined as percentage of LGE to LV mass (%LGE) using software CVI 42. The scar heterogeneity, quantified by entropy within the scar and LV myocardium was derived. The presence of VAs was defined as previous aborted cardiac arrest, documented sustained ventricular tachycardia (VT) and non-stained VT (nsVT) by Holter or implantable cardiac devices (ICD) monitoring. A total of 68 HCM patients (54.6 ±14.3 years, 69.1% male, LVEF 67.2 ±12.9 %) with LGE CMR were enrolled with a median follow-up of 25 (IQR 13-13) months. Thirty-one patients in VAs group and 37 patients in No-VAs group were included. From multivariable analysis, higher entropy of the scar (Hazard ratio [HR] 2.682;95% confidence interval [CI]:1.022 to 7.037; P=0.039) was independently associated with VAs, after adjusting for LVEF, %LGE, the LV maximal wall thickness (MWT) and the left atrium (LA) diameter. High entropy within the scar was an independent predictor of VAs and may indicate an arrhythmogenic scar. It seemed to be valuable for assessing the clinical status of VAs in HCM patients.