{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:20:31Z","timestamp":1792268431625,"version":"4.4.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,9,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Greater precision is required for arrhythmic risk stratification of patients with nonischemic cardiomyopathy (NICM). We sought to evaluate whether fibrosis entropy, a measure of scar texture heterogeneity derived from late gadolinium enhancement cardiovascular magnetic resonance, has incremental utility to fibrosis presence for arrhythmic risk prediction in NICM.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">In this prospective observational cohort study, fibrosis entropy was calculated for patients with NICM and fibrosis (late gadolinium enhancement positive, LGE+), including regions of core fibrosis, gray zone fibrosis and combined core and gray zone fibrosis. Patients with NICM and no fibrosis (LGE\u2010) were included as a comparator group. Adjudicated follow\u2010up for life\u2010threatening arrhythmia included sudden cardiac death, aborted sudden cardiac death, or sustained ventricular tachycardia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Of 291 patients with LGE+ NICM, 38 (13.1%) experienced life\u2010threatening arrhythmia over a median follow\u2010up of 6.3\u2009years. Core fibrosis entropy (per\u2010SD hazard ratio [HR], 1.77 [95% CI, 1.25\u20132.52];\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.001), gray zone fibrosis entropy (HR, 1.97 [95% CI, 1.20\u20132.54];\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.004), and combined fibrosis entropy (HR, 1.98 [95% CI, 1.30\u20133.02];\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.004) were each associated with life\u2010threatening arrhythmia after adjustment for variables used to determine implantable cardioverter\u2010defibrillator candidacy in clinical practice (left ventricular ejection fraction \u226435% and New York Heart Association class &gt;1) and remained associated after accounting for core and gray zone fibrosis mass. Left ventricular ejection fraction \u226435% was not associated with life\u2010threatening arrhythmia (HR, 1.45 [95% CI, 0.77\u20132.74];\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.250). Integration of fibrosis presence with fibrosis entropy classified patients into low\u2010, intermediate\u2010, and high\u2010arrhythmic\u2010risk groups.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Deeper phenotypic characterization of scar using fibrosis entropy offers incremental utility to left ventricular ejection fraction and fibrosis presence for arrhythmic risk stratification in NICM.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.040517","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T11:49:24Z","timestamp":1757591364000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Fibrosis Entropy Is Associated With Life\u2010Threatening Arrhythmia in Nonischemic Cardiomyopathy"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1164-5993","authenticated-orcid":false,"given":"Daniel J.","family":"Hammersley","sequence":"first","affiliation":[{"name":"King\u2019s College Hospital NHS Foundation Trust","place":["London, United Kingdom"]},{"name":"King\u2019s College London","place":["London, United Kingdom"]},{"name":"Guy\u2019s & St Thomas\u2019 NHS Trust","place":["London, United Kingdom"]},{"name":"Imperial College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2806-9483","authenticated-orcid":false,"given":"Hassan A.","family":"Zaidi","sequence":"additional","affiliation":[{"name":"King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7869-8061","authenticated-orcid":false,"given":"Richard 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