Entropy as a Novel Measure of Myocardial Tissue Heterogeneity for Prediction of MACE in Patients with Myocarditis

Motivation: Better way to assess myocardial histological changes in patients with myocarditis is desired. Goal(s): Assess the utility of entropy, a novel measure of myocardial heterogeneity, for predicting cardiovascular events in patients with acute myocarditis. Approach: Patients included were diagnosed with acute myocarditis by cardiac MRI or endomyocardial biopsy. Left ventricular entropy, scar entropy, LGE presence, LGE mass and LGE extent were derived. Results: Entropy and scar entropy of patients in MACE group was significantly higher than that of No MACE group. Entropy maintained an independent association with MACE in a multivariable model including clinical presentation, left ventricular ejection fraction, and LGE extent. Impact: LV entropy is a fully reproducible and highly prognostic measure of myocardial heterogeneity. It shows promising ability to predict adverse cardiovascular events in patients with acute myocarditis.