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Correlation and diagnostic value of left ventricular entropy based on late gadolinium enhancement and myocardial fibrosis imaging markers with heart failure with preserved ejection fraction
YANG Xianglin  WANG Wenxian  GAO Yan  WANG Linxiang  XUE Runjie  LI He  WANG Ximing 

DOI:10.12015/issn.1674-8034.2025.11.004.


[Abstract] Objective To explore the correlation between left ventricular entropy (LV entropy) based on cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) and myocardial fibrosis imaging markers including Native T1 mapping and extracellular volume fraction (ECV) in patients with heart failure with preserved ejection fraction (HFpEF), as well as its diagnostic value for these patients.Materials and Methods A total of 150 patients diagnosed with HFpEF at Shandong Provincial Hospital between May 2019 and April 2023 were retrospectively included in the study. They were divided into two groups based on the presence of late gadolinium enhancement regions[the LGE (+) group (110 cases) and the LGE (-) group (40 cases)]. Additionally, 59 healthy individuals were selected as the control group.They were randomly split into the training set and validation set at an 8∶2 ratio. The Spearman correlation coefficient was used to examine the relationship between Native T1 mapping, ECV and LV entropy. The diagnostic efficacy of different parameters was assessed by receiver operating characteristic (ROC) curves.Results LV entropy was moderately positively correlated with both Native T1 mapping and ECV (r = 0.48, r = 0.68, respectively; P < 0.001) in all patients. In subgroups of patients with positive LGE, LV entropy was moderately positively correlated with Native T1 mapping, and strongly correlated with ECV (r = 0.57, r = 0.74, respectively; P < 0.001). In subgroups of patients with negative LGE, LV entropy moderately positively correlated with ECV (r = 0.36; P = 0.024), but not significantly correlated with Native T1 mapping. ROC curve analysis showed that in both the training set and the validation set, the diagnostic efficacy of left ventricular entropy was higher than that of Native T1 mapping and ECV. The AUC values were 0.895, 0.732, 0.748 (for the training set) and 0.893, 0.731, 0.747 (for the validation set), respectively. The AUC values of the combined model of the three parameters were 0.916 (training set) and 0.914 (validation set), respectively. The DeLong test showed that the diagnostic performance was improved after the combined of CMR parameters (P < 0.05).Conclusions Left ventricular entropy derived from CMR-LGE can characterize extracellular space heterogeneity. It provides supplementary value to traditional imaging markers of myocardial fibrosis in detecting pathological changes in patients with HFpEF, and also exhibits certain diagnostic value for these patients.
[Keywords] cardiac magnetic resonance；late gadolinium enhancement；left ventricular entropy；T1 mapping；extracellular volume fraction；heart failure

YANG Xianglin1, 2   WANG Wenxian2, 3   GAO Yan2   WANG Linxiang1   XUE Runjie4   LI He1   WANG Ximing1, 2*  

1 Medical Integration and Practice Center of Shandong University, Jinan 250012, China

2 Department of Radiology, Shandong Provincial Hospital, Jinan 250021, China

3 Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan 250117, China

4 School of Medical Imaging, Binzhou Medical University, Yantai 264003, China

Corresponding author: WANG X M, E-mail: wxming369@163.com

Conflicts of interest   None.

Received  2025-08-20
Accepted  2025-11-06
DOI: 10.12015/issn.1674-8034.2025.11.004
DOI:10.12015/issn.1674-8034.2025.11.004.

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