Evaluating Phase Entropy from Gated SPECT-MPI as a Predictor of Major Adverse Cardiovascular Events: Added Prognostic Insights Beyond Perfusion and Function

To determine the independent prognostic value of phase entropy for predicting major adverse cardiovascular events (MACE).

Study Population: Retrospective analysis of 1,674 coronary artery disease patients undergoing gated SPECT-MPI, followed for a median of 36.6 months.
Data Collection: Collected demographic and clinical data, including cardiovascular risk factors and imaging results.
Statistical Analysis: Evaluated the association between phase entropy and MACE using multivariable adjustment and predictive modeling.

An U-shaped association between phase entropy and MACE was identified (P = 0.005).
Patients with abnormal phase entropy (>53% or ≤31%) exhibited significantly lower survival rates compared to those with normal values (31%–53%, P < 0.001).
Phase entropy remained an independent predictor of MACE after multivariable adjustment.
Inclusion of phase entropy improved MACE prediction beyond total perfusion deficit (TPD) and left ventricular ejection fraction (LVEF) (P < 0.05).

Phase entropy ≤31% or >53% correlates with reduced survival.

The study is retrospective and may be subject to selection bias.
The generalizability of findings may be limited to the specific patient population studied.

Phase entropy is an independent predictor of MACE, providing prognostic insights beyond traditional measures.